Efficacy and safety of dupilumab monotherapy in adults with moderate-to-severe atopic dermatitis: a pooled analysis of two phase 3 randomized trials (LIBERTY AD SOLO 1 and LIBERTY AD SOLO 2).


Journal

Journal of dermatological science
ISSN: 1873-569X
Titre abrégé: J Dermatol Sci
Pays: Netherlands
ID NLM: 9011485

Informations de publication

Date de publication:
May 2019
Historique:
received: 30 10 2018
revised: 07 02 2019
accepted: 13 02 2019
pubmed: 22 5 2019
medline: 3 4 2020
entrez: 22 5 2019
Statut: ppublish

Résumé

Two phase 3 trials with identical design, LIBERTY AD SOLO 1 (NCT02277743) and LIBERTY AD SOLO 2 (NCT02277769), confirmed dupilumab efficacy and safety versus placebo in adults with moderate-to-severe atopic dermatitis (AD). To report a pooled analysis of these trials to further explore dupilumab's effects on AD clinical parameters, patient-reported outcomes (PROs), symptoms of anxiety/depression, health-related quality of life (HRQoL), and safety. A pooled analysis of two 16-week phase 3 studies in adults with moderate-to-severe AD (N = 1379) inadequately controlled with/inadvisable for topical medications, randomized to dupilumab 300 mg once weekly (qw), every 2 weeks (q2w), or placebo. Dupilumab significantly improved all pre-specified efficacy endpoints versus placebo (P < 0.0001), including clinical severity outcomes and PROs, symptoms of anxiety/depression, and HRQoL, consistent with previously published results. In post-hoc analyses, among patients reporting at least some baseline pain/discomfort on the EuroQoL-5D, no pain/discomfort at Week 16 was reported by 43%/46%/14% of dupilumab qw/q2w/placebo-treated patients (P < 0.0001). The distribution of dupilumab-treated patients within pre-defined score categories on the Investigator's Global Assessment (0-1/2/3/4) and Eczema Area and Severity Index (≥90%/≥75-<90%/≥50-<75%/<50%) steadily and consistently improved over time versus marginal changes with placebo. Dupilumab significantly improved pruritus within 1-3 days of treatment initiation. No new safety signals were observed. Injection-site reactions and conjunctivitis were more common with dupilumab; AD exacerbation and non-herpetic skin infections more frequent with placebo. Dupilumab versus placebo significantly improved objective AD signs, subjective PROs, symptoms of anxiety/depression, and HRQoL, with a favorable benefit-risk profile in adults with moderate-to-severe AD.

Sections du résumé

BACKGROUND BACKGROUND
Two phase 3 trials with identical design, LIBERTY AD SOLO 1 (NCT02277743) and LIBERTY AD SOLO 2 (NCT02277769), confirmed dupilumab efficacy and safety versus placebo in adults with moderate-to-severe atopic dermatitis (AD).
OBJECTIVES OBJECTIVE
To report a pooled analysis of these trials to further explore dupilumab's effects on AD clinical parameters, patient-reported outcomes (PROs), symptoms of anxiety/depression, health-related quality of life (HRQoL), and safety.
METHODS METHODS
A pooled analysis of two 16-week phase 3 studies in adults with moderate-to-severe AD (N = 1379) inadequately controlled with/inadvisable for topical medications, randomized to dupilumab 300 mg once weekly (qw), every 2 weeks (q2w), or placebo.
RESULTS RESULTS
Dupilumab significantly improved all pre-specified efficacy endpoints versus placebo (P < 0.0001), including clinical severity outcomes and PROs, symptoms of anxiety/depression, and HRQoL, consistent with previously published results. In post-hoc analyses, among patients reporting at least some baseline pain/discomfort on the EuroQoL-5D, no pain/discomfort at Week 16 was reported by 43%/46%/14% of dupilumab qw/q2w/placebo-treated patients (P < 0.0001). The distribution of dupilumab-treated patients within pre-defined score categories on the Investigator's Global Assessment (0-1/2/3/4) and Eczema Area and Severity Index (≥90%/≥75-<90%/≥50-<75%/<50%) steadily and consistently improved over time versus marginal changes with placebo. Dupilumab significantly improved pruritus within 1-3 days of treatment initiation. No new safety signals were observed. Injection-site reactions and conjunctivitis were more common with dupilumab; AD exacerbation and non-herpetic skin infections more frequent with placebo.
CONCLUSIONS CONCLUSIONS
Dupilumab versus placebo significantly improved objective AD signs, subjective PROs, symptoms of anxiety/depression, and HRQoL, with a favorable benefit-risk profile in adults with moderate-to-severe AD.

Identifiants

pubmed: 31109652
pii: S0923-1811(19)30028-3
doi: 10.1016/j.jdermsci.2019.02.002
pii:
doi:

Substances chimiques

Antibodies, Monoclonal, Humanized 0
Placebos 0
dupilumab 420K487FSG

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

266-275

Informations de copyright

Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.

Auteurs

Diamant Thaçi (D)

Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany. Electronic address: diamant.thaci@uksh.de.

Eric L Simpson (E)

Department of Dermatology, Oregon Health and Science University, Portland, OR, USA.

Mette Deleuran (M)

Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark.

Yoko Kataoka (Y)

Department of Dermatology, Osaka Habikino Medical Center, Habikino, Osaka, Japan.

Zhen Chen (Z)

Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA.

Abhijit Gadkari (A)

Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA.

Laurent Eckert (L)

Sanofi, Chilly-Mazarin, France.

Bolanle Akinlade (B)

Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA.

Neil M H Graham (NMH)

Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA.

Gianluca Pirozzi (G)

Sanofi, Bridgewater, NJ, USA.

Marius Ardeleanu (M)

Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA.

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Classifications MeSH