Instrumental evaluation of skin barrier function and clinical outcomes during dupilumab treatment for atopic dermatitis: An observational study

Cristaudo, Antonio; Pigliacelli, Flavia; Sperati, Francesca; Orsini, Diego; Cameli, Norma; Morrone, Andrea; Mariano, Maria

doi:10.1111/srt.13025

Cited by 11 publications

(18 citation statements)

References 17 publications

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“…A study similar to ours has already been performed in a cohort of 30 AD patients treated with dupilumab, showing that there was an inverse proportional correlation between TEWL and disease severity after 8 weeks of dupilumab treatment. 28 Moreover, Rohner et al 29 demonstrated in 10 AD patients that dupilumab led to a significant increased expression of epithelial barrier proteins [filaggrin, lymphoepithelial-Kazal-type-related inhibitor (LEKTI), human β-defensin-3 and cathelicidin LL-37]. Similar conclusions were drawn by Guttman-Yassky et al , 20 who found increased expression of the epidermal differentiation, barrier and lipid metabolism genes filaggrin, loricrin, claudins and ELOVL3.…”

Section: Discussionmentioning

confidence: 70%

Skin barrier status during dupilumab treatment in patients with severe atopic dermatitis

Ferrucci

Romagnuolo

Maronese

et al. 2021

Therapeutic Advances in Chronic Disease

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Background: Atopic dermatitis (AD) is a common chronic-relapsing inflammatory skin disease hallmarked by epidermal barrier dysfunction, increased transepidermal water loss (TEWL) and decreased skin hydration. Recent findings on the T helper 2 (Th2)-driven pathogenesis of AD have led to the development of dupilumab, a monoclonal antibody directed against interleukin-4 and interleukin-13 that has been demonstrated to be effective in the treatment of moderate-to-severe AD. The effect of dupilumab on skin barrier dysfunction, however, has not yet been adequately investigated. Objectives: The primary endpoint of this study was to assess the status of the skin barrier in nonlesional skin of patients with severe AD treated with dupilumab, by evaluating the association between the relative variation of TEWL and the achievement of a 75% reduction of EASI (EASI75) over time. Methods: TEWL was measured below the antecubital fossae by means of the Vapometer® at baseline, at week 4 (T4), at week 16 (T16) and at week 32 after dupilumab starting. EASI and NRS-itch were measured at the same time points. Results: Seventy-eight patients with severe AD treated with dupilumab were enrolled. Median TEWL relative variation respect to baseline was significantly higher in patients who achieved EASI75 as compared with those who did not achieve EASI75 at T16 and at T32, but not at T4. Conclusion: During dupilumab treatment, TEWL on nonlesional skin tends to significantly improve 4 months after treatment initiation and could be a good tool for monitoring response to therapy.

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Section: Discussionmentioning

confidence: 70%

Skin barrier status during dupilumab treatment in patients with severe atopic dermatitis

Ferrucci

Romagnuolo

Maronese

et al. 2021

Therapeutic Advances in Chronic Disease

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“…Empty Hy and Rm (bare R. mucosa ) showed moderate therapeutic effects, while Hy@Rm alleviated AD symptoms much more effectively. In AD patients, skin barrier destruction is associated with the increase of trans-epidermal water loss (TEWL), and the reduction of skin hydration/elasticity [ 56 ]. Regarding these indicators of skin conditions, there appeared an evident improvement of skin status, as evidenced by the remarkably reduced TEWL ( Fig.…”

Section: Resultsmentioning

confidence: 99%

Living symbiotic bacteria-involved skin dressing to combat indigenous pathogens for microbiome-based biotherapy toward atopic dermatitis

Liu

Qin²,

Dong³

et al. 2023

Bioactive Materials

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“…We also observed that dupilumab decreases TEWL and increases SCH, reflecting skin barrier recovery. The lack of differences in SCH in other studies may be explained by the shorter follow-up [ 46 ] or the limited number of participants [ 47 ]. Moreover, we also found that dupilumab decreases temperature, which might be reflecting a reduction in the inflammatory load, while we did not find changes in pH.…”

Section: Discussionmentioning

confidence: 99%

“…Some other studies have also evaluated the impact of dupilumab on skin barrier function [ 46 , 47 , 48 , 49 , 50 ]. They showed that dupilumab reduced TEWL on non-involved and involved skin [ 46 , 47 , 48 , 49 , 50 ]. The impact of dupilumab in SCH differs between studies.…”

Section: Discussionmentioning

confidence: 99%

“…The impact of dupilumab in SCH differs between studies. Cristaudo et al found reported a decreasing trend in SCH values in 30 patients with AD after 8 weeks of treatment [ 46 ] while Furuhashi et al found that SCH did not change after 24 weeks of dupilumab treatment in seven patients [ 47 ]. We also observed that dupilumab decreases TEWL and increases SCH, reflecting skin barrier recovery.…”

Section: Discussionmentioning

confidence: 99%

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Dupilumab Improves Skin Barrier Function in Adults with Atopic Dermatitis: A Prospective Observational Study

Montero‐Vílchez

Rodríguez-Pozo

Díaz-Calvillo

et al. 2022

JCM

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Epidermal barrier dysfunction plays an important role in atopic dermatitis (AD). The difficulty of objectively assessing AD severity and the introduction of new biologicals into clinical practice highlight the need to find parameters to monitor clinical outcomes. The aim of this study is to evaluate the impact of dupilumab on skin barrier function and compare it with other treatments in patients with AD. A prospective observational study was conducted in adults with AD treated with topical corticosteroids (TCS), cyclosporine, or dupilumab. The main outcome measures after 16 weeks of treatment were Eczema Area and Severity (EASI)-50 (50% improvement in EASI), and transepidermal water loss (TEWL)-50 (50% improvement in TEWL). Forty-six patients with AD were included in the study. The proportion of patients who achieved EASI-50 at week 16 was significantly higher in patients receiving dupilumab (81.8% vs. 28.6% vs. 40%, p = 0.004). In eczematous lesions, TEWL decreased in patients receiving dupilumab (31.02 vs. 12.10 g·h−1·m−2, p < 0.001) and TCS (25.30 vs. 14.88 g·h−1·m−2, p = 0.047). The proportion of patients who achieved TEWL-50 at week 16 was higher for dupilumab than for cyclosporine or TCS. Temperature only decreased in the dupilumab group. Stratum corneum hydration increased in eczematous lesions and non-involved skin only in patients with dupilumab. In conclusion, dupilumab improves skin barrier function in patients with AD better than TCS or cyclosporine, both in eczematous lesions and in non-lesioned skin.

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Instrumental evaluation of skin barrier function and clinical outcomes during dupilumab treatment for atopic dermatitis: An observational study

Cited by 11 publications

References 17 publications

Skin barrier status during dupilumab treatment in patients with severe atopic dermatitis

Skin barrier status during dupilumab treatment in patients with severe atopic dermatitis

Living symbiotic bacteria-involved skin dressing to combat indigenous pathogens for microbiome-based biotherapy toward atopic dermatitis

Dupilumab Improves Skin Barrier Function in Adults with Atopic Dermatitis: A Prospective Observational Study

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