An Observational Study of Early Treatment Response and Predictors of Dupilumab in the Treatment of Moderate-to-Severe Atopic Dermatitis

IF 3.7 4区医学 Q1 DERMATOLOGY Dermatologic Therapy Pub Date : 2024-07-10 DOI:10.1155/2024/5782827

Sisi Deng, Huan Wang, Jiong Fu, Zhifang Zhai, Qiquan Chen, Zhiqiang Song

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Abstract

Background. Dupilumab has shown good effectiveness and safety in patients with moderate-to-severe atopic dermatitis. However, there is a lack of clinical data that focuses solely on the treatment response for the endpoint to observe the short-term goal (12 weeks) in the treatment-to-target (T2T) concept. Study on predictors of early treatment response is also limited. Objective. To evaluate the early effectiveness and safety of dupilumab in the treatment of moderate-to-severe atopic dermatitis and to identify possible predictors of response. Methods. Using a retrospective study method, patients with moderate-to-severe atopic dermatitis who received dupilumab for ≥12 weeks at the Southwest Hospital between September 2019 and April 2022 were included. Results. Totally 16.25% of patients achieved EASI75 after 4 weeks and 53.75% achieved EASI75 after 12 weeks. SCORAD, EASI, and NRS were 50.17 ± 17.35, 13.51 ± 12.33 and 7.10 ± 1.82 in turn at baseline, and decreased to 29.94 ± 15.01, 6.97 ± 7.92, 3.64 ± 1.39 and 14.96 ± 10.31, 3.05 ± 4.16, 2.19 ± 1.09 after 4 and 12 weeks, respectively, with statistically significant differences (p < 0.01). After 12 weeks, the changes in peripheral blood eosinophil count (decreased from (0.60 ± 0.43) ∗ 10^9/L to (0.30 ± 0.21) ∗ 10^9/L), total IgE level (decreased from 547.00 (179.00, 2167.50) IU/ml to 216.50 (106.00, 825.00) IU/ml), and LDH (decreased from (166.11 ± 171.59) IU/L to (67.54 ± 70.68) IU/L) from baseline were significant (p < 0.01). Elevated peripheral blood eosinophil counts might be associated with an inadequate response to dupilumab (SCORAD12w: p = 0.007; EASI12w: p = 0.003; NRS12w: p = 0.030). The most common adverse events were reactions at the injection site (6/80) and conjunctivitis (4/80). Conclusion. Dupilumab showed good early effectiveness and safety in real-world practice in Chinese patients with moderate-to-severe atopic dermatitis.

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杜匹单抗治疗中重度特应性皮炎的早期治疗反应和预测因素观察研究

背景介绍杜比鲁单抗对中重度特应性皮炎患者具有良好的疗效和安全性。然而，在 "治疗到目标"（T2T）的概念中，缺乏仅以治疗反应为终点来观察短期目标（12 周）的临床数据。有关早期治疗反应预测因素的研究也很有限。研究目的评估杜比鲁单抗治疗中重度特应性皮炎的早期有效性和安全性，并确定可能的反应预测因素。方法：采用回顾性研究方法。采用回顾性研究方法，纳入2019年9月至2022年4月期间在西南医院接受杜度单抗治疗≥12周的中重度特应性皮炎患者。研究结果共有16.25%的患者在4周后达到EASI75，53.75%的患者在12周后达到EASI75。基线时SCORAD、EASI和NRS分别为（50.17±17.35）、（13.51±12.33）和（7.10±1.82），4周和12周后分别降至（29.94±15.01）、（6.97±7.92）、（3.64±1.39）和（14.96±10.31）、（3.05±4.16）、（2.19±1.09），差异有统计学意义（P <0.01）。12 周后，外周血嗜酸性粒细胞计数（从（0.60 ± 0.43）∗ 10^9/L 降至（0.30 ± 0.21）∗ 10^9/L）、总 IgE 水平（从 547.00（179.00，2167.50）IU/ml降至216.50（106.00，825.00）IU/ml），LDH（从（166.11 ± 171.59）IU/L降至（67.54 ± 70.68）IU/L）与基线相比均有显著性差异（p <0.01）。外周血嗜酸性粒细胞计数升高可能与对杜匹单抗的反应不充分有关（SCORAD12w：p = 0.007；EASI12w：p = 0.003；NRS12w：p = 0.030）。最常见的不良反应是注射部位反应（6/80）和结膜炎（4/80）。结论杜比鲁单抗在中国中重度特应性皮炎患者的实际治疗中显示出良好的早期有效性和安全性。

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来源期刊

Dermatologic Therapy 医学-皮肤病学

CiteScore

7.00

自引率

8.30%

发文量

711

审稿时长

3 months

期刊介绍： Dermatologic Therapy has been created to fill an important void in the dermatologic literature: the lack of a readily available source of up-to-date information on the treatment of specific cutaneous diseases and the practical application of specific treatment modalities. Each issue of the journal consists of a series of scholarly review articles written by leaders in dermatology in which they describe, in very specific terms, how they treat particular cutaneous diseases and how they use specific therapeutic agents. The information contained in each issue is so practical and detailed that the reader should be able to directly apply various treatment approaches to daily clinical situations. Because of the specific and practical nature of this publication, Dermatologic Therapy not only serves as a readily available resource for the day-to-day treatment of patients, but also as an evolving therapeutic textbook for the treatment of dermatologic diseases.