Impact on health‐related quality of life and symptoms of anxiety and depression after 32 weeks of Dupilumab treatment for moderate‐to‐severe atopic dermatitis

Abstract

Dupilumab is the first biological agent approved for treatment of moderate-to-severe atopic dermatitis (AD). Evidence of Dupilumab effectiveness on psychological outcomes beyond 16 weeks of treatment from real-life settings is lacking. To evaluate the effectiveness of Dupilumab treatment up to 32 weeks, focusing health-related quality of life and psychological outcome of patients with moderate-to-severe AD. An observational prospective cohort study was conducted in a real-life setting at an Italian tertiary centre. Assessment of outcome measures was carried out at baseline, after 16 and 32 weeks of treatment. A total of 171 patients were included. EASI-75 and EASI-90 were achieved in 85% and 60% of the participants, respectively, after 16 weeks, and in 89.6% and 69.8% after 32 weeks of treatment. Significant improvements (p < 0.001; r = 0.57-0.95) were found after 16 weeks for each outcome considered, including clinician and patient-reported measures of AD severity and scales of health-related quality of life and psychological morbidity, and maintained up to 32 weeks. Further analysis revealed that patients' quality of life was more associated with the subjective perception of disease severity rather than objective measures and suggested a possible different response to treatment based on the age of AD onset. Dupilumab was confirmed to be rapid, effective and safe in patients with moderate-to-severe AD. Its positive impact on psychological outcomes up to 32 weeks was ascertained here, adding new evidence on the need to consider subjective factors affecting patients' perception of disease severity in evaluating the response to treatment.

Involvement of Atopic Dermatitis in the Development of Systemic Inflammatory Diseases

“…Although the detailed molecular mechanism of AD and psychological disorders remains unclear, higher IL-4 and IL-13 serum levels (Th2) were also observed in a group with a major depressive disorder [ 93 ]. Dupilumab treatment impairs anxiety and depressive symptoms [ 94 , 95 ], suggesting the possible importance of systemic therapy against the psychological disorder development in addition to a possible role of Th2 immune response in the pathogenesis of psychological disorders.…”

National Saudi Consensus Statement on the Management of Atopic Dermatitis (2021)

“…Combining dupilumab with a conventional drug or phototherapy is an appropriate and safe therapy option which allows patients recalcitrant to dupilumab monotherapy [ 99 ]. Subsequent real-life studies have confirmed the data from the registration studies in clinical practice, regarding efficacy, safety, and improvement of patient-reported outcomes [ 100 , 101 ]…”

Chronic Pruritus in Atopic Patients Treated with Dupilumab: Real Life Response and Related Parameters in 354 Patients

“…The biological, clinical, and psychological factors and parameters of AD that correlate with the symptoms of pruritus, particularly during systemic therapy, have not been well-defined yet in the literature on this subject [ 3 ]. Real-life experiences of pruritus during treatment with dupilumab and the possible associated factors are scarce, as well as possible differences between adolescent and adult populations [ 7 , 10 ].…”