Two-year efficacy, safety, and drug survival of dupilumab for atopic dermatitis: A real-world Canadian multicenter retrospective study

Georgakopoulos, Jorge R.; Felfeli, Tina; Drucker, Aaron M.; Jo, Christine E.; Piguet, Vincent; Yeung, Jensen

doi:10.1016/j.jdin.2021.06.001

Cited by 14 publications

(12 citation statements)

References 4 publications

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“…Thirty-five per cent of our patients reported AEs in the 2-year follow-up, which is similar to 32-35% in three studies with 1 year follow-up from Italy and Portugal, [13][14][15] but lower than 61% observed in a Czech study with 2-year follow-up. 7 One in four patients reported conjunctivitis, which is comparable to other studies with long follow-up, 5,6,13,15,16 while also markedly higher than selected studies with up to 2-year follow-up. 9,14,17 Differences in reporting patterns and specific focus on conjunctivitis and preventive initiatives with artificial tears might explain the differences.…”

Section: Safetysupporting

confidence: 79%

“…[2][3][4][5] However, few studies have so far investigated the same daily-practice parameters and drug survival beyond 52-weeks' follow-up, and none have been based on nationwide complete datasets. [6][7][8][9] We examined the short-and long-term safety, effectiveness and drug survival of dupilumab treatment in a Danish nationwide cohort of patients with moderate-to-severe AD. The cohort is embedded in the prospective, multicentre Severe and ChRonic Atopic dermatitis Treatment CoHort (SCRATCH) registry, including virtually all Danish patients treated with dupilumab for AD.…”

mentioning

confidence: 99%

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A nationwide 104 weeks real‐world study of dupilumab in adults with atopic dermatitis: Ineffectiveness in head‐and‐neck dermatitis

Vittrup

Krogh²,

Larsen

et al. 2023

Acad Dermatol Venereol

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Atopic dermatitis (AD) is a chronic, pruritic, inflammatory skin disease that is common in adults. 1 Most patients obtain disease control with trigger avoidance, and frequent use of emollients and anti-inflammatory topical treatments. However, some patients need systemic therapy to reduce AD activity and severity. A few systemic immunomodulating drugs have traditionally been used for the treatment of AD including methotrexate and azathioprine, although only cyclosporine is approved in Europe.Dupilumab, a monoclonal antibody targeting the IL-4Rα-subunit of the IL4 and IL13-receptor, reduces type 2 inflammation. In January 2018, dupilumab was approved in Denmark for treatment of adults with moderate-tosevere AD. Real-world evidence studies have confirmed the

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Section: Safetysupporting

confidence: 79%

mentioning

confidence: 99%

A nationwide 104 weeks real‐world study of dupilumab in adults with atopic dermatitis: Ineffectiveness in head‐and‐neck dermatitis

Vittrup

Krogh²,

Larsen

et al. 2023

Acad Dermatol Venereol

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“…Overall, the number of patients who discontinued dupilumab treatment was consistent with our results. Georgakopoulos et al 16 assessed the 2-year drug survival of dupilumab in a clinical population of patients with AD. Drug survival of dupilumab was 83% and 80% after 1 year and 2 years of treatment.…”

Section: Discussionmentioning

confidence: 99%

Dupilumab Drug Survival and Associated Predictors in Patients With Moderate to Severe Atopic Dermatitis

et al. 2022

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ImportanceLong-term data on dupilumab drug survival in patients with atopic dermatitis (AD) are scarce. Furthermore, little is known about the factors associated with drug survival of dupilumab in AD.ObjectiveTo describe the drug survival of dupilumab in patients with AD and to identify associated predictors.Design, Setting, and ParticipantsThis cohort study was based on data from the multicenter prospective daily practice BioDay registry, in which 4 university and 10 nonuniversity hospitals in the Netherlands participated. Analysis included patients (age ≥18 years) participating in the BioDay registry with a follow-up of at least 4 weeks. The first patient treated with dupilumab was recorded in the BioDay registry in October 2017; data lock took place in December 2020, and data analysis was performed from October 2017 to December 2020.Main Outcomes and MeasuresDrug survival was analyzed by Kaplan-Meier survival curves and associated characteristics by using univariate and multivariate Cox regression analysis.ResultsA total of 715 adult patients with AD (mean [SD] age, 41.8 [16.0] years; 418 [58.5%] were male) were included with a 1-year, 2-year, and 3-year overall dupilumab drug survival of 90.3%, 85.9%, and 78.6%, respectively. Characteristics associated with shorter drug survival owing to ineffectiveness were the use of immunosuppressant drugs at baseline (hazard ratio [HR], 2.64; 95% CI, 1.10-6.37) and being a nonresponder at 4 weeks (HR, 8.68; 95% CI, 2.97-25.35). Characteristics associated with shorter drug survival owing to adverse effects were the use of immunosuppressant drugs at baseline (HR, 2.69; 95% CI, 1.32-5.48), age 65 years or older (HR, 2.94; 95% CI, 1.10-7.87), and Investigator Global Assessment score of very severe AD (HR, 3.51; 95% CI, 1.20-10.28).Conclusions and RelevanceThis cohort study demonstrated a good overall 1-year, 2-year, and 3-year dupilumab drug survival. Patients using immunosuppressive therapy at baseline and those with an absence of treatment effect at week 4 tended to discontinue treatment owing to ineffectiveness more frequently. Using immunosuppressant drugs at baseline, older age, and Investigator Global Assessment score of very severe AD were characteristics associated with an increased risk for discontinuation owing to adverse effects. These data provide more insight and new perspectives regarding dupilumab treatment in AD and can contribute to the optimization of patient outcomes.

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“…This is increasingly important as research now support long-term use of dupilumab for some patients’ disease management. 24 …”

Section: Discussionmentioning

confidence: 99%

Characterising the chronicity of dupilumab-associated ocular surface disease: an analysis of a retrospective case series

Hébert

You

et al. 2022

BMJ Open Ophth

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Background/aimsTo describe the clinical presentation and treatment response of dupilumab-associated ocular surface disease (DAOSD).MethodsThis is a retrospective case series of atopic dermatitis patients with DAOSD treated with dupilumab. All consecutive patients with atopic dermatitis referred by dermatologists for suspicion of DAOSD between May 2018 and June 2020 were systemically assessed by a single ophthalmologist. Presenting signs of DAOSD, duration of treatment and associated response are described.ResultsTwenty-eight patients had DAOSD during the study period. Average age was 45.6±14.8 years and 13 (46%) were female. Average follow-up was 15±10 months. Most presentations consisted in diffuse, inflammatory conjunctivitis (n=19, 68%). Other signs included peripheral corneal infiltrates (n=7, 25%), limbal nodules (n=7, 25%) and dry eye syndrome (n=6, 21%). To control ocular symptoms, tapering of corticosteroid eyedrops was slow: taper duration of strong and mild corticosteroid eyedrops averaged 10±8 weeks and 49±34 weeks, respectively. Four patients (14%) required an increase of corticosteroid eyedrops during taper due to clinical deterioration. Corticosteroid eyedrops were still required at final follow-up among 10 patients (36%). Dupilumab was temporarily stopped in 3 patients (11%), one of which did not wish to resume dupilumab for unrelated reasons. Symptomatic improvement and/or complete resolution was achieved in 25/26 patients at follow-up (96%) with empirical treatment.ConclusionsDAOSD may follow the course of a chronic illness. Long-term corticosteroid eyedrops were required in many patients and when taper was possible, this was done after a prolonged treatment duration. Most patients’ ocular symptoms could be controlled, allowing dupilumab continuation.

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Two-year efficacy, safety, and drug survival of dupilumab for atopic dermatitis: A real-world Canadian multicenter retrospective study

Cited by 14 publications

References 4 publications

A nationwide 104 weeks real‐world study of dupilumab in adults with atopic dermatitis: Ineffectiveness in head‐and‐neck dermatitis

A nationwide 104 weeks real‐world study of dupilumab in adults with atopic dermatitis: Ineffectiveness in head‐and‐neck dermatitis

Dupilumab Drug Survival and Associated Predictors in Patients With Moderate to Severe Atopic Dermatitis

Characterising the chronicity of dupilumab-associated ocular surface disease: an analysis of a retrospective case series

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