Dupilumab treatment in paediatric atopic dermatitis (2 to 18 years): Spanish multicentre retrospective real-life study.


Journal

Clinical and experimental dermatology
ISSN: 1365-2230
Titre abrégé: Clin Exp Dermatol
Pays: England
ID NLM: 7606847

Informations de publication

Date de publication:
02 Aug 2024
Historique:
received: 29 05 2024
revised: 15 07 2024
accepted: 31 07 2024
medline: 2 8 2024
pubmed: 2 8 2024
entrez: 2 8 2024
Statut: aheadofprint

Résumé

Moderate-to-severe atopic dermatitis (AD) can be difficult to manage in paediatric patients, with few licensed treatments in this age group. Dupilumab is approved for AD in children older than 6 months. To assess the effectiveness and safety of dupilumab in a real-life cohort of paediatric AD patients in Spain. A multicentre, retrospective real-life study on the effectiveness and safety of dupilumab in patients aged 2 to 18 years old with moderate-to-severe AD was conducted. Demographic and clinical characteristics were analysed, and effectiveness (EASI, IGA, DLQI, NRS itch), safety, and drug survival measures were assessed. A comparison of our results with other real-world outcomes and with clinical trials was made. Data from 243 patients from 19 centres was collected, with a mean follow-up of 85 weeks. Dupilumab exhibited significant effectiveness, with marked reductions in severity scores from week 4. By week 16, 79.4% of patients reached EASI75 and 40.5% reached EASI90. Mean percentage reduction in EASI was 79.7%. Increasing improvements were observed until week 52, with 85.8% and 49.6% achieving EASI75 and EASI90, respectively. Forty-three patients developed adverse events (AE) (43/243, 17.7%), being the most frequent ocular surface diseases (20/243, 8.2%), injection site reactions (8/243, 3.3%) and facial redness (7/243, 2.9%). Drug survival was high (96.9% and 93.1% after 1 and 2 years of follow-up, respectively), with only 19 (19/243, 7.8%) patients interrupting treatment: 7 (7/243, 2.9%) due to AE, 2 (2/243, 0.82%) due to secondary failure, 5 (5/243, 2.1%) were lost to follow-up and 5 (5/243, 2.1%) entered remission and stopped treatment. Real-life use of dupilumab in paediatric AD showcased sustained effectiveness, high drug survival, and acceptable safety profiles. Longer-term studies are crucial for AE surveillance and how to manage disease remission.

Sections du résumé

BACKGROUND BACKGROUND
Moderate-to-severe atopic dermatitis (AD) can be difficult to manage in paediatric patients, with few licensed treatments in this age group. Dupilumab is approved for AD in children older than 6 months.
OBJECTIVES OBJECTIVE
To assess the effectiveness and safety of dupilumab in a real-life cohort of paediatric AD patients in Spain.
METHODS METHODS
A multicentre, retrospective real-life study on the effectiveness and safety of dupilumab in patients aged 2 to 18 years old with moderate-to-severe AD was conducted. Demographic and clinical characteristics were analysed, and effectiveness (EASI, IGA, DLQI, NRS itch), safety, and drug survival measures were assessed. A comparison of our results with other real-world outcomes and with clinical trials was made.
RESULTS RESULTS
Data from 243 patients from 19 centres was collected, with a mean follow-up of 85 weeks. Dupilumab exhibited significant effectiveness, with marked reductions in severity scores from week 4. By week 16, 79.4% of patients reached EASI75 and 40.5% reached EASI90. Mean percentage reduction in EASI was 79.7%. Increasing improvements were observed until week 52, with 85.8% and 49.6% achieving EASI75 and EASI90, respectively. Forty-three patients developed adverse events (AE) (43/243, 17.7%), being the most frequent ocular surface diseases (20/243, 8.2%), injection site reactions (8/243, 3.3%) and facial redness (7/243, 2.9%). Drug survival was high (96.9% and 93.1% after 1 and 2 years of follow-up, respectively), with only 19 (19/243, 7.8%) patients interrupting treatment: 7 (7/243, 2.9%) due to AE, 2 (2/243, 0.82%) due to secondary failure, 5 (5/243, 2.1%) were lost to follow-up and 5 (5/243, 2.1%) entered remission and stopped treatment.
CONCLUSION CONCLUSIONS
Real-life use of dupilumab in paediatric AD showcased sustained effectiveness, high drug survival, and acceptable safety profiles. Longer-term studies are crucial for AE surveillance and how to manage disease remission.

Identifiants

pubmed: 39093288
pii: 7726145
doi: 10.1093/ced/llae300
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© The Author(s) 2024. Published by Oxford University Press on behalf of British Association of Dermatologists. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

Auteurs

Helena Iznardo (H)

Department of Dermatology, Hospital de la Santa Creu i Sant Pau, IR SANT PAU, Universitat Autònoma de Barcelona, Barcelona, Spain.

Esther Roé (E)

Department of Dermatology, Hospital de la Santa Creu i Sant Pau, IR SANT PAU, Universitat Autònoma de Barcelona, Barcelona, Spain.

Asunción Vicente (A)

Department of Dermatology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain.

Carolina Prat (C)

Department of Dermatology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain.

Miquel Casals (M)

Department of Dermatology, Hospital Universitari de Sabadell, Sabadell, Spain.

Ana Martín-Santiago (A)

Department of Dermatology, Hospital Universitari Son Espases, Palma, Spain.

Altea Esteve (A)

Department of Dermatology, Consorcio Hospital Universitario General de Valencia, Valencia, Spain.

Miguel Viñas (M)

Department of Dermatology, Hospital Sant Antoni Abat, Vilanova I la Gertrú, Spain.

Mónica Munera-Campos (M)

Department of Dermatology, Hospital Universitari Germans Trias i Pujol. Germans Trias I Pujol Research Institute (IGTP). Universitat Autònoma de Barcelona (UAB). Badalona, Spain.

Francesca Corella (F)

Department of Dermatology, Hospital Universitari Mútua de Terrassa, Terrasa, Spain.

Jordi Mollet (J)

Department of Dermatology, Hospital Universitari Vall d'Hebrón, Barcelona, Spain.

Ignasi Figueras Nart (I)

Department of Dermatology, Hospital de Bellvitge, Barcelona, Spain.

Aina Vila (A)

Department of Dermatology. Hospital de Manacor, Manacor, Spain.

Xavier Soria (X)

Department of Dermatology. Hospital Universitari Arnau de Vilanova, Lleida, Spain.

Antoni Azón-Masoliver (A)

Department of Dermatology. Hospital Universitari Sant Joan de Reus, Reus, Spain.

Laura Marqués-Martín (L)

Department of Dermatology. Hospital Santa Caterina, Girona, Spain.

Cristina Nadal-Lladó (C)

Department of Dermatology. Hospital Son Llàtzer, Palma, Spain.

Susana Bel (S)

Department of Dermatology. Hospital Comarcal d'Amposta, Amposta, Spain.

Josep Pujol-Montcusí (J)

Department of Dermatology. Hospital Universitari Joan XXIII, Tarragona, Spain.

Marta Bertolín-Colilla (M)

Department of Dermatology. Hospital del Mar de Barcelona, Barcelona, Spain.

Laia Curto-Barredo (L)

Department of Dermatology. Hospital del Mar de Barcelona, Barcelona, Spain.

Gemma Melé-Ninot (G)

Department of Dermatology. Hospital Universitari Sagrat Cor, Grupo Quirónsalud, Barcelona, Spain.

Montserrat Evole (M)

Department of Dermatology. Hospital Universitari i Politècnic la Fe, Valencia, Spain.

Laura Berbegal (L)

Department of Dermatology. Hospital General Universitario Dr Balmis, Alicante, Spain.

Lluís Puig (L)

Department of Dermatology, Hospital de la Santa Creu i Sant Pau, IR SANT PAU, Universitat Autònoma de Barcelona, Barcelona, Spain.

Eulàlia Baselga (E)

Department of Dermatology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain.

Classifications MeSH