Effectiveness and safety of dupilumab for the treatment of atopic dermatitis in a real-life French multicenter adult cohort

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY

卷:81

Article

Faiz, Sarah¹  Giovannelli, Jonathan^1,2  Podevin, Celine²  Jachiet, Marie^3,4  Bouaziz, Jean-David^3,4  Reguiai, Ziad⁵  Nosbaum, Audrey^6,7  Lasek, Audrey⁸  le Bouedec, Marie-Christine Ferrier⁹  Aurelie Du Thah¹⁰  Raison-Peyron, Nadia¹⁰  Tetart, Florence¹¹  Duval-Modeste, Anne-Benedicte¹¹  Misery, Laurent¹²  Aubin, Francois¹³  Dompmartin, Anne¹⁴  Morice, Cecile¹⁴  Droitcourt, Catherine¹⁵  Soria, Angele^16,17  Arnault, Jean-Philippe¹⁸  Delaunay, Juliette¹⁹  Mahe, Emmanuel²⁰  Richard, Marie-Aleth²¹  Schoeffler, Amelie²²  Lacour, Jean-Philippe²³  Begon, Edouard²⁴  Walter-Lepage, Amelie²⁵  Dillies, Anne-Sophie²⁶  Rappelle-Duruy, Sandrine²⁷  Barete, Stephane²⁸  Bellon, Nathalia²⁹  Beneton, Nathalie³⁰  Valois, Aude³¹  Barbarot, Sebastien³²  Senechal, Julien^33,34  Staumont-Salle, Delphine^1,2 

[1] CHU Lille, Serv Dermatol, F-59000 Lille, France

[2] Univ Lille, INSERM U995, Lille Inflammat Res Int Ctr, F-59000 Lille, France

[3] Dermatol Dept, Paris, France

[4] Univ Paris Diderot Paris VII, St Louis Hosp, AP HP, Sorbonne Paris Cite, Paris, France

[5] Polyclin Courlancy, Serv Dermatol, Reims, France

[6] Univ Lyon, Lyon Sud Univ Hosp, Allergy & Clin Immunol Dept, Lyon, France

[7] Univ Claude Bernard Lyon 1, INSERM U1111, Int Ctr Infectiol Rese, Ecole Normale Super Lyon, Lyon, France

[8] Hosp St Vincent Paul, Grp Hop Inst Catholique Lille, Serv Dermatol, Lille, France

[9] Univ Clermont Ferrand, Dermatol Dept, Clermont Ferrand, France

[10] Univ Montpellier, Serv Dermatol, CHU Montpellier, PCCI,INSERM, Montpellier, France

[11] Rouen Univ Hosp, Dept Dermatol, Inserm U519, Rouen, France

[12] Univ Hosp Brest, Dept Dermatol, Brest, France

[13] Univ Franche Comte, Serv Dermatol, Ctr Hosp Reg Univ Besancon, Besancon, France

[14] Caen Univ Hosp Ctr, Dept Dermatol, Caen, France

[15] Univ Rennes, Ctr Hosp Univ Pontchaillou, Serv Dermatol, Rennes, France

[16] Hop Tenon, AP HP, Paris HUEP, Serv Dermatol & Allergol, Paris, France

[17] Sorbonne Univ Paris, Cimi Paris, INSERM U1135, Paris, France

[18] Amiens Univ Hosp, Dept Dermatol, Amiens, France

[19] CHU Angers, Serv Dermatol, Angers, France

[20] Hop Victor Dupouy Argenteuil, Dept Dermatol, Argenteuil, France

[21] Aix Marseille Univ, Timone Hosp, AP HM, EA 3279,CEReSS Hlth Serv Res & Qual Life Ctr,Derm, F-13385 Marseille, France

[22] Ctr Hosp Reg Metz Thionville, Serv Dermatol, Hop Bel Air, Metz, France

[23] CHU Nice, Serv Dermatol, Hop Archet 2, Nice, France

[24] Ctr Hosp Rene Dubos, Serv Dermatol, Pontoise, France

[25] CHU La Miletrie, Serv Dermatol, Poitiers, France

[26] Ctr Hosp St Quentin, Serv Dermatol, St Quentin en Yvelines, France

[27] Hop Joseph Imbert, Serv Dermatol, Ctr Hosp Arles, St Quentin en Yvelines, France

[28] Sorbonne Univ, Hop La Pitie Salpetriere, AP HP, Unite Fonct Dermatol, Paris, France

[29] Hop Necker Enfants Malad, AP HP, Serv Dermatol, Paris, France

[30] Ctr Hosp Le Mans, Serv Dermatol, Le Mans, France

[31] Hop Instruct Armees St Anne, Serv Dermatol, Toulon, France

[32] CHU Nantes, Serv Dermatol, Nantes, France

[33] CHU Bordeaux, Hop St Andre, Serv Dermatol, Ctr Reference Malad Rares Peau, Bordeaux, France

[34] Univ Bordeaux, INSERM Biotherapie Malad Genet Inflammatoires & C, Immunodermatol ATIP AVENIR, Bordeaux, France

关键词: adults;    atopic dermatitis;    biotherapy;    conjunctivitis;    dupilumab;    eosinophilia;   

DOI  :  10.1016/j.jaad.2019.02.053

来源: Elsevier

【 摘 要 】

Background: Dupilumab is the first biologic available to treat atopic dermatitis (AD). Its effectiveness and safety were demonstrated in clinical trials. Objective: We sought to assess the effectiveness and safety of dupilumab in adults with AD in a real-life French multicenter retrospective cohort. Methods: We included patients treated during March 2017-April 2018. Efficacy outcomes, including Scoring Atopic Dermatitis (SCORAD) and Eczema Area and Severity Index (EASI) scores, were collected at baseline and 3 months when available. Adverse events (AEs) were recorded at follow-up. Results: We included 241 patients. The median 6 interquartile range (IQR) follow-up time was 3.8 +/- 3.7 months. A >= 75% improvement in SCORAD was achieved in 27 of 163 (16.6%) patients, and a >= 75% improvement in EASI was achieved in 40 of 82 (48.8%) patients. The median SCORAD and EASI scores at 3 months were significantly lower than those at baseline (SCORAD +/- IQR, 25 +/- 21 vs 56 +/- 27.4, P < 10(-9) and EASI +/- IQR, 4.1 +/- 6.8 vs 17.9 +/- 15.4, P < 10(-9), respectively). Conjunctivitis was reported in 84 of 241 (38.2%) patients. The proportion with eosinophilia (<500 cells/mm(3)) during follow-up (57%) was higher than that at baseline (33.7%) (n = 172, P < 10(-6)). Dupilumab was stopped in 42 cases; 27 patients stopped because of AEs. Limitations: No control group, missing data. Conclusion: This real-life study demonstrated a similar dupilumab effectiveness as that seen in clinical trials, but it also revealed a higher frequency of conjunctivitis and eosinophilia.

【 授权许可】

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