Dupilumab shows long-term effectiveness in a large cohort of treatment-refractory atopic dermatitis patients in daily practice: 52-Week results from the Dutch BioDay registry - 17/02/21

Doi : 10.1016/j.jaad.2020.08.127

Lieneke F.M. Ariëns, MD ^a,^⁎ , Jorien van der Schaft, MD, PhD ^a, Lotte S. Spekhorst, MD ^a, Daphne S. Bakker, MD ^a, Geertruida L.E. Romeijn ^b, Tessa A. Kouwenhoven, MD ^c, Marijke Kamsteeg, MD, PhD ^c, Angelique N. Voorberg, MD ^b, Albert J. Oosting, MD ^d, Ilona de Ridder, BA ^a, Annemieke Sloeserwij ^a, Inge Haeck, MD, PhD ^e, Judith L. Thijs, MD, PhD ^a, Marie L.A. Schuttelaar, MD, PhD ^b, Marjolein S. de Bruin-Weller, MD, PhD ^a
^a National Expertise Center for Atopic Dermatitis, Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht, the Netherlands
^b Department of Dermatology, University Medical Center Groningen, Groningen, the Netherlands
^c Department of Dermatology, Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands
^d Department of Dermatology, Spaarne Ziekenhuis, the Netherlands
^e Department of Dermatology, Reinier de Graaf Gasthuis, Delft, the Netherlands

^∗Correspondence to: Lieneke F. M. Ariëns, MD, Universitair Medisch Centrum Utrecht, Heidelberglaan 100, Utrecht 3584 CX, Netherlands.Universitair Medisch Centrum UtrechtHeidelberglaan 100Utrecht3584 CXNetherlands

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Abstract

Background

Real-life data on long-term effectiveness and safety of dupilumab in atopic dermatitis patients are limited.

Objective

To study 52-week effectiveness and safety of dupilumab in a prospective multicenter cohort of adult patients with treatment-refractory atopic dermatitis.

Methods

Patients treated with dupilumab and participating in the Dutch BioDay registry were included. Clinical effectiveness and safety were evaluated.

Results

Two hundred ten atopic dermatitis patients were included. Mean percentage change in Eczema Area and Severity Index score after 16 weeks was –70.0% (standard deviation 33.2%) and further decreased to –76.6% (standard deviation 30.6%) by week 52. A greater than or equal to 75% improvement in the score was achieved by 59.9% of individuals by week 16 and by 70.3% by week 52. The most reported adverse effect was conjunctivitis (34%). Limited patients (17; 8.1%) discontinued dupilumab treatment.

Limitations

Because of the lack of a control group and observational design, factors of bias may have been induced.

Conclusion

Treatment with dupilumab resulted in a rapid improvement in clinical outcome measures, and effectiveness further improved during the 52-week follow-up period.

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Key words : atopic dermatitis, daily practice, disease severity, dupilumab, effectiveness, long-term, safety

Abbreviations used : EASI, IL, IQR, LIBERTY AD CHRONOS, NRS

Plan

Introduction

Methods

Study design

Patients and outcome measures

Effectiveness of dupilumab treatment

Longitudinal effectiveness of dupilumab treatment

Adverse effects

Dupilumab dose adjustment

Discontinuation of dupilumab treatment

Discussion

	Drs Ariëns, van der Schaft, Schuttelaar, and de Bruin-Weller contributed equally to this article.
	Funding sources: Supported by Sanofi and Regeneron Pharmaceuticals.
	Conflicts of interest: Dr Schuttelaar reports being an advisory board member for and receiving consulting fees from Sanofi Genzyme. Dr de Bruin-Weller reports being a principal investigator, consultant, and advisory board member for AbbVie, Regeneron Pharmaceuticals, Inc, Sanofi Genzyme, Leo Pharma, and Pfizer; and an advisory board member and consultant for Eli Lilly. Drs Ariëns, van der Schaft, Spekhorst, Bakker, Kouwenhoven, Kamsteeg, Voorberg, Oosting, Haeck, and Thijs and Authors Romeijn, Ridder, and Sloeserwij have no conflicts of interest to declare.
	IRB approval status: The BioDay registry was considered noninterventional by the local medical ethics committee and collection of data was performed according to the Helsinki Declaration.
	Reprints not available from the authors.