Abstract
Dupilumab is used to treat atopic dermatitis (AD) patients who have proven to be refractory to previous treatments. The aim of this study was to assess evolution and patient reported outcome measures in adult patients with moderate-to-severe AD treated with dupilumab in routine clinical practice. The outcomes were evaluated and registered at baseline and weeks 16, 40 and 52. The variables evaluated were: disease severity, pruritus, stressful life events, difficulty to sleep, anxiety and depression, quality of life, satisfaction, adherence to the treatment, efficacy and safety. Eleven patients were recruited between 14 Nov 2017 and 16 Jan 2018. Demographic variables: 90% Caucasian, 82% women. Clinical variables: Mean duration of AD = 17.7 (±12.8), 91% had severe disease severity. At baseline, SCORAD median (range) score = 69.2 (34.8–89.2); itch was reported by 100% of patients; itch visual analogue scale median (range) was 9 (6–10); HADS median (range) total score = 13 (5–21); DLQI mean score = 16 (2–27); EQ-5D-3L median (range) = 57 (30–99). At week-52 there was a significant reduction of SCORAD scores median (range) = 4.3 (0–17.1), HADS total score median (range) = 2 (0–10) and improved quality of life EQ-5D-3L median (range) = 89 (92–60). This study confirms that dupilumab, used for 52-weeks under routine clinical practice, maintains the improved atopic dermatitis signs and symptoms obtained at week 16, with a good safety profile.
Highlights
Atopic dermatitis (AD), a chronic inflammatory skin disease that evolves as flares, is characterized by itching and eczema
The study group comprised of 11 adult patients, of which nine (81.8%) were females; six (54.5%) had secondary studies and five (45.5%) had university studies; eight lived with family (72.7%) and three (27.3%) alone; three were students (27.3%), five (45.5%) were active workers, one (9.1%) was unemployed and one (9.1%) was on sick leave; five patients
The results of this study show that dupilumab 300 mg q2w in monotherapy promotes a rapid and sustained statistically significant improvement in the Scoring Atopic Dermatitis (SCORAD) score of adults with moderate to severe atopic dermatitis at week 16, which is maintained until week 52
Summary
Atopic dermatitis (AD), a chronic inflammatory skin disease that evolves as flares, is characterized by itching and eczema. AD affects 2–10% of adults [1] and, in severe cases, is associated with significant psychosocial distress [2]. Moderate-to-severe AD requires long-term immunosuppressive therapy of which the efficacy profile and longterm adverse effects are not clear [3,4,5,6]. Treatment guidelines recommend short-term high-strength topical corticosteroids with or without calcineurin inhibitors to control outbreaks, in addition to topical emollients [7,8]. Systemic treatment with corticosteroids or immunosuppressants (cyclosporine, methotrexate, azathioprine, etc.), and phototherapy are indicated only in cases not controlled by topical treatment [9,10]. Long-term systemic treatments are not indicated due to their bad safety and efficacy profile [11,12]
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