No Increased Risk of Overall Infection in Adults with Moderate-to-Severe Atopic Dermatitis Treated for up to 4Years with Dupilumab.

Abstract

Patients with atopic dermatitis (AD) have an increased risk for infections. This open-label extension study, LIBERTY AD OLE, reports the incidence of infections in adults with moderate-to-severe AD treated with dupilumab for up to 4years. We evaluated infections in adults with moderate-to-severe AD treated with dupilumab 300mg weekly (qw) or every 2weeks (q2w; approved regimen) for up to 4years. Topical corticosteroids (TCS) and calcineurin inhibitors (TCI) were permitted. Exposure-adjusted incidence rates (number of patients with at least one event per 100 patient-years [nP/100PY]) are reported. Overall, 2677 patients were enrolled and treated with dupilumab: 352 (13.1%) completed up to week204; 226 patients (8.4%) switched from qw to q2w during the trial. Rates of overall infections (71.27nP/100PY), serious and/or severe infections (1.39nP/100PY), and infections leading to discontinuation (0.34nP/100PY) were consistent with a previous 3-year analysis of this study and low compared with 1-year results in adults with AD treated with placebo + TCS. The cumulative number of patients with treatment-emergent serious or severe infections, non-herpetic or herpetic infections, and total skin infections decreasedyear-over-year. Limitations included open-label study design with no placebo arm; decreasing sample size at later time points due to sponsor decision to close sites following regulatory approval; qw dosing differs from approved q2w dosing; and patients could use TCS/TCI throughout the study, which may have impacted infection rates. Continuous long-term dupilumab treatment in adults with moderate-to-severe AD is not associated with an increased risk of overall systemic or cutaneous infections. ClinicalTrials.gov Identifier: NCT01949311. Video Abstract INFOGRAPHIC.