Real-World Experience and Laboratory Monitoring of Dupilumab in Patients with Moderate to Severe Atopic Dermatitis in a Tertiary Centre

Abstract

Introduction Dupilumab is a biologic therapy approved for treatment of moderate to severe atopic dermatitis (AD). Our objective was to assess the real-world effectiveness, safety and laboratory monitoring practices for dupilumab in a tertiary centre. Methods A retrospective review of medical records of all patients receiving dupilumab between September 2017 and October 2019 was undertaken. Eczema Area and Severity Index (EASI) and Dermatology Life Quality Index (DLQI) were collected at weeks 0, 12–16 and 26–30. Data on laboratory tests undertaken for dupilumab screening and monitoring were also collected. Results At 12–16 weeks, 58.9% and 37.3% of patients achieved ≥ EASI 75 and ≥ EASI 90, respectively ( n = 156). Ninety-four patients underwent further analysis at weeks 26–30 with those achieving ≥ EASI 75 increasing from 61.7% (12–16 weeks) to 75.31%, and EASI 90 increasing from 35.8% (12–16 weeks) to 49.8%. The most common side effects were eye symptoms occurring in 43.1% of patients, with 16.3% developing conjunctivitis. The mean treatment duration was 255 days, during which an average of three sets of blood tests were performed ( n = 149). Of all laboratory abnormalities recorded, 24% started after initiation of dupilumab, and 93% were classified as ‘mild’. Dupilumab was not documented as causative in any of the cases, nor was treatment stopped on account of laboratory abnormalities. Conclusion Dupilumab provides an effective and safe treatment option for patients with AD. Clinical response continued to improve past 16 weeks in this real-world population. No laboratory abnormalities were felt to be secondary to dupilumab; screening and monitoring tests did not influence dupilumab prescribing. Electronic supplementary material The online version of this article (10.1007/s13555-020-00469-6) contains supplementary material, which is available to authorised users.

A Literature Review of Real-World Effectiveness and Safety of Dupilumab for Atopic Dermatitis

“…Real-world evidence of the effectiveness and safety of dupilumab for atopic dermatitis Accumulating real-world evidence has ensured the effectiveness and tolerable safety of dupilumab both in the short term and in the long term. The articles searched in PubMed and Google Scholar are shown in Table 1 (Ariëns et al, 2020, Ariëns et al, 2021, Faiz et al, 2019, Fargnoli et al, 2020, Fargnoli et al, 2019, Jang et al, 2020, Jo et al, 2020a, Kreeshan et al, 2021, Matsutani et al, 2020, Nettis et al, 2020b, Nettis et al, 2020c, Olesen et al, 2019, Patruno et al, 2021a, Patruno et al, 2021b, Quint et al, 2020, Ribero et al, 2020, Sears et al, 2020, Tauber et al, 2019, Uchida et al, 2021, Uchida et al, 2019. Patruno et al reported the effectiveness and safety of dupilumab in elderly patients with AD in real life (Patruno et al, 2021a, Patruno et al, 2021b.…”

“…Accumulating real-world evidence has ensured the effectiveness and tolerable safety of dupilumab both in the short term and in the long term. The articles searched in PubMed and Google Scholar are shown in Table 1 ( Ariëns et al., 2021 , 2020 ; Armario-Hita et al., 2019 ; Faiz et al., 2019 ; Fargnoli et al, 2020 , 2019 ; Ferrucci et al., 2020 ; Jang et al., 2020 ; Jo et al., 2020a , 2020b ; Kim et al., 2020 ; Kreeshan et al., 2021 ; Matsutani et al., 2020 ; Nettis et al., 2020b , 2020c ; Olesen et al., 2019 ; Patruno et al., 2021a , 2021b ; Quint et al., 2020 ; Ribero et al., 2020 ; Sears et al., 2021 ; Tauber et al., 2019 ; Tavecchio et al., 2020 ; Uchida et al., 2021 , 2019 ; Wang et al., 2020 ; Yamauchi et al., 2021 ). Patruno et al.…”

“… The most frequently reported adverse events were nasopharyngitis (n = 4, 11.8%) and conjunctivitis (n = 4, 11.8%). Kreeshan et al. (2021) United Kingdom 30 164 75.31 The most common side effects were eye symptoms, occurring in 43.1% of patients, with 16.3% developing conjunctivitis.…”

Efficacy and Safety of Dupilumab in Clinical Practice: One Year of Experience on 165 Adult Patients from a Tertiary Referral Centre

“…We have read with great interest the article by Kreeshan et al, which reported data on effectiveness and laboratory safety of dupilumab in a real-word cohort of 164 patients affected by atopic dermatitis (AD) followed over 12--30 weeks [1]. The authors reported that 58.96% of patients achieved at least a 75% improvement in eczema area severity index (EASI75), while 37.31% achieved EASI90 at 12-16 weeks.…”

Efficacy and Safety of Dupilumab in Chinese Patients With Atopic Dermatitis: A Real-World Study

“…Recent studies supported that after dupilumab treatment, patients who achieved clinical improvement in at least one of primary (EASI 75) or secondary (NRS peak pruritus improvement ≥4 or DLQI improvement ≥4) endpoints were considered to have experienced good therapeutic effects ( 16 – 18 ). Additionally, dupilumab has an acceptable safety profile, and does not require laboratory monitoring during the working period ( 19 ).…”