Dupilumab: A review of its use in the treatment of atopic dermatitis - 21/02/18
Abstract |
Atopic dermatitis (AD) is a chronic, pruritic immune-mediated inflammatory dermatosis characterized by a T helper 2 (Th2) immune response phenotype and may be associated with systemic inflammation. Dupilumab is an interleukin 4 (IL-4) receptor α-antagonist that inhibits IL-4 and IL-13 signaling through blockade of the shared IL-4α subunit. Blockade of IL-4/13 is effective in reducing Th2 response. Dupilumab has recently been approved in the United States and Europe for the treatment of adult patients with moderate-to-severe AD. Clinical trials have shown that adults with moderate-to-severe AD who receive weekly or biweekly dupilumab injections have significantly improved clinical and patient-reported outcomes, including Eczema Area Severity Index, SCORing Atopic Dermatitis, Dermatology Life Quality Index, and itch Numeric Rating Scale scores. Concomitant use of topical corticosteroids along with dupilumab results in a greater improvement in signs and symptoms of AD than with use of dupilumab alone. Biomarker analyses show that dupilumab modulates the AD molecular signature and other Th2-associated biomarkers. Common adverse events reported in the clinical trials were nasopharyngitis, upper respiratory tract infection, injection site reactions, skin infections, and conjunctivitis. These were mild-to-moderate in nature, and overall rates of adverse events occurred with similar frequency between the treatment and placebo groups. There were no significant serious safety concerns identified in phase III clinical trials. Dupilumab, as monotherapy or with concomitant use of topical corticosteroids, can significantly improve clinical outcomes and quality of life in patients suffering from moderate-to-severe AD. Ongoing studies of dupilumab will help determine the clinical efficacy and safety profile of its long-term use.
Le texte complet de cet article est disponible en PDF.Key words : biologics, dupilumab, IL-4, IL-13, IL-4Rα, moderate-to-severe atopic dermatitis, systemic therapy
Abbreviations used : AD, ADA, CCL, CYP450, DLQI, EASI, IGA, IL, NRS, TCS, Th2
Plan
Publication of this article was supported by Leo Pharma, Bayer, and Sanofi/Regeneron. |
|
Funding sources: Supported by Bayer, LEO Pharma, and Sanofi. |
|
Disclosure: Dr Gooderham has served as an investigator, speaker, consultant and advisory board member for AbbVie, Actelion, Akros, Amgen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Dermira, Eli Lilly, Galderma, GSK, Incyte, Janssen, Leo Pharma, Medimmune, Novartis, Pfizer, Regeneron, Roche, Sanofi Genzyme, UCB, and Valeant. Dr Hong has served as an investigator, speaker, consultant, and advisory board member for Abbvie, Amgen, Boehringer Ingelheim, Celgene, Dermavant, Dermira, Eli Lilly, Galderma, GSK, Incyte, Leo Pharma, Medimmune, Novartis, Pfizer, Roche, Regeneron, Sanofi Genzyme, and Valeant. Dr Papp has served as an investigator, speaker, consultant, and advisory board member for AbbVie, Akros, Allergan, Amgen, Anacor, Astellas, AstraZeneca, Baxalta, Baxter, Boehringer Ingelheim, Bristol-Myers Squibb, CanFile, Celgene, Dermavant, Dermira, Eli Lilly, Forward Pharma, Galderma, Genentech, GSK, Incyte, Janssen, Kyowa Hakko Kirin, LEO Pharma, Medimmune, Meiji Seika Pharma, Merck, Merck Serono, Mitsubishi Pharma, Novartis, Pfizer, Regeneron, Roche, Sanofi Genzyme, Takeda, UCB, and Valeant. Ms Eshtiaghi disclosed no conflicts of interest. |
|
Reprints not available from the authors. |
Vol 78 - N° 3S1
P. S28-S36 - mars 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?