Dupilumab treatment induced similar improvements in signs, symptoms, and quality of life in adults with moderate-to-severe atopic dermatitis with baseline Eczema Area and Severity Index Score <24 or ≥24.

Abstract

BACKGROUND:

In multiple phase 3 trials, dupilumab improved signs, symptoms (including pruritus), and quality-of-life (QoL) in adults with moderate-to-severe atopic dermatitis (AD). In Italy, dupilumab received innovation status but is currently only reimbursed by the National Health Service for adults with Eczema Area Severity Index (EASI) scores ≥24. This analysis assesses disease burden and dupilumab efficacy in adults with EASI scores above and below this threshold.

METHODS:

This post-hoc analysis included 299 adults pooled from two, randomized, placebo-controlled, phase 3 trials, LIBERTY AD CAFÉ (NCT02755649) and LIBERTY AD CHRONOS (NCT02260986), who received the approved dupilumab regimen (300 mg every 2 weeks) or placebo, with concomitant topical corticosteroids. EASI, Peak Pruritus Numerical Rating Scale (PP-NRS), and Dermatology Life Quality Index (DLQI) were assessed in patients with EASI scores ≥20 to <24 and ≥24 at week 16.

RESULTS:

At baseline, EASI was weakly correlated with PP-NRS and DLQI (Spearman's correlation coefficient: 0.22 and 0.29, respectively). At week 16, in both the EASI<24 and EASI≥24 populations, respectively, significantly more patients vs. control achieved: ≥50% improvement in EASI (95.5% vs. 55.6%; 80.6% vs. 33.1%); ≥3-point improvement in PP-NRS (68.4% vs. 35.3%; 55.3% vs. 17.7%); and ≥4-point improvement in DLQI (83.3% vs. 43.8%; 84.2% vs. 41.9%); from baseline. Dupilumab was generally well tolerated with an acceptable safety profile.

CONCLUSIONS:

Dupilumab treatment improves signs, symptoms, and QoL in moderate-to-severe AD adults with EASI<24, who can present with high disease burden. Opportunity may exist to use additional parameters to define disease severity and access to new therapies.

• Authors: Annamaria Offidani, Luca Stingeni, Iria Neri, Filippo Cipriani, Zhen Chen, Ana B Rossi, Yufang Lu, Devis Moretti
• Journal: Italian journal of dermatology and venereology (Ital J Dermatol Venerol) Vol. 157 Issue 1 Pg. 39-46 (Feb 2022) ISSN: 2784-8450 [Electronic] Italy
• PMID: 33878856 (Publication Type: Journal Article)

Chemical References

• Antibodies, Monoclonal, Humanized
• dupilumab

Topics

• Adult
• Antibodies, Monoclonal, Humanized
• Dermatitis, Atopic (diagnosis)
• Double-Blind Method
• Eczema
• Humans
• Quality of Life
• State Medicine
• Treatment Outcome