杜匹单抗对中重度特应性皮炎的短期、中期和长期疗效:一项针对 2576 名患者的意大利多中心实际研究。

IF 3.7 4区 医学 Q1 DERMATOLOGY Clinical and Experimental Dermatology Pub Date : 2024-11-22 DOI:10.1093/ced/llae208
Silvia Ferrucci, Simona Tavecchio, Carlo Alberto Maronese, Anna Balato, Eugenia Veronica Di Brizzi, Michela Ortoncelli, Simone Ribero, Giampiero Girolomoni, Martina Maurelli, Anna Belloni Fortina, Francesca Caroppo, Luigi Naldi, Elena Pezzolo, Eustachio Nettis, Francesco Pugliese, Luca Stingeni, Katharina Hansel, Giovanni Rubegni, Laura Calabrese, Filomena Russo, Massimo Gola, Elisabetta Magnaterra, Franco Rongioletti, Santo Raffaele Mercuri, Giovanni Paolino, Paola Savoia, Federica Veronese, Caterina Foti, Francesca Ambrogio, Massimiliano Scalvenzi, Maddalena Napolitano, Cataldo Patruno, Stefano Dastoli, Monica Corazza, Alessandro Borghi, Pier Giacomo Calzavara-Pinton, Mariateresa Rossi, Annamaria Offidani, Giulia Radi, Laura Bonzano, Caterina Ferreli, Viviana Piras, Rosanna Satta, Federica Sucato, Piergiorgio Malagoli, Francesca Gaiani, Giuseppe Micali, Maria Letizia Musumeci, Maria Concetta Fargnoli, Maria Esposito, Teresa Grieco, Camilla Chello, Giovanni Casazza, Angelo Valerio Marzano
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引用次数: 0

摘要

背景:方法:进行了一项多中心、回顾性、动态队列研究,以评估在真实世界环境中杜比鲁单抗对中重度特应性皮炎(AD)患者的长期有效性和安全性。研究调查了最小疾病活动度(MDA)最佳治疗目标标准(定义为同时达到EASI90、瘙痒NRS评分≤1、睡眠NRS评分≤1和DLQI≤1)的预测因素。结果:2018年6月至2022年7月,2576名患者入组。随访4个月、12个月、24个月、36个月和48个月的患者中,分别有506人(21.91%)、769人(40.63%)、628人(50.36%)、330人(55.37%)和58人(54.72%)达到了MDA最佳治疗目标标准。逻辑回归显示,在所有时间点,结膜炎和食物过敏对 MDA 指标的影响均为负。在随访 4、12、24、36 和 48 个月的患者中,分别有 373 人(15.78%)、166 人(7.02%)、83 人(6.43%)、27 人(4.50%)和 5 人(4.55%)出现轻微不良事件(AE)。结膜炎是随访期间最常报告的 AE。结论:杜必利的长期有效性和安全性很高:无论基线时的临床表型和病程如何,中度至重度 AD 患者的动态队列均证实了杜比鲁单抗的长期有效性和安全性。还需要进一步研究Th2合并症和病程对dupilumab和其他AD新疗法反应的影响。
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Short-, mid- and long-term efficacy of dupilumab in moderate-to-severe atopic dermatitis: a real-world multicentre Italian study of 2576 patients.

Background: The efficacy and safety of dupilumab in atopic dermatitis (AD) have been defined in clinical trials but limited real-world evidence on long-term treatment outcomes is currently available to inform clinical decisions.

Objectives: To describe the long-term effectiveness and safety of dupilumab up to 48 months in patients with moderate-to-severe AD.

Methods: A multicentre, retrospective, dynamic cohort study was conducted to assess long-term effectiveness and safety of dupilumab in patients with moderate-to-severe AD in a real-world setting. Predictors of minimal disease activity (MDA) optimal treatment target criteria [defined as the simultaneous achievement of a 90% reduction in Eczema Area and Severity Index score, itch-numeric rating scale (NRS) score ≤ 1, sleep-NRS score ≤ 1 and Dermatology Life Quality Index ≤ 1] were investigated.

Results: In total, 2576 patients were enrolled from June 2018 to July 2022. MDA optimal treatment target criteria were achieved by 506/2309 (21.9%), 769/1959 (39.3%), 628/1247 (50.4%), 330/596 (55.4%) and 58/106 (54.7%) of those that reached 4, 12, 24, 36 and 48 months of follow-up, respectively. Logistic regression revealed a negative effect on MDA achievement for conjunctivitis and food allergy at all timepoints. Adverse events (AEs) were mild and were observed in 373/2364 (15.8%), 166/2066 (8.0%), 83/1291 (6.4%), 27/601 (4.5%) and 5/110 (4.5%) of those that reached 4, 12, 24, 36 and 48 months of follow-up. Conjunctivitis was the most frequently reported AE during the available follow-up. AEs led to treatment discontinuation in < 1% of patients during the evaluated time periods.

Conclusions: The high long-term effectiveness and safety of dupilumab were confirmed in this dynamic cohort of patients with moderate-to-severe AD, regardless of clinical phenotype and course (persisting or relapsing) at baseline. Further research will be needed to investigate the effect of T helper cell 2 comorbidities and disease duration on the response to dupilumab and other newer therapeutics for AD.

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来源期刊
CiteScore
3.20
自引率
2.40%
发文量
389
审稿时长
3-8 weeks
期刊介绍: Clinical and Experimental Dermatology (CED) is a unique provider of relevant and educational material for practising clinicians and dermatological researchers. We support continuing professional development (CPD) of dermatology specialists to advance the understanding, management and treatment of skin disease in order to improve patient outcomes.
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