McGregor Sean, Farhangian Michael E, Feldman Steven R
a 1 Wake Forest School of Medicine, Center for Dermatology Research, Medical Center Boulevard, Department of Dermatology , Winston-Salem, NC, USA +1 33 67 16 77 40 ; +1 33 67 16 77 32 ;
b 2 Wake Forest School of Medicine, Department of Pathology , Winston-Salem, NC, USA.
Expert Opin Biol Ther. 2015;15(11):1657-60. doi: 10.1517/14712598.2015.1076388. Epub 2015 Aug 28.
Current treatment options for moderate-to-severe atopic dermatitis (AD) are limited and have potentially dangerous side effects. Dupilumab is a novel monoclonal antibody that was recently studied in adult patients with moderate-to-severe AD. Dupilumab inhibits interleukin-4 (IL-4) and interleukin-13 (IL-13) signaling and was previously found to be effective in asthma. Considering that both AD and asthma are Th2 cell-mediated inflammatory processes, it is reasonable to suspect that dupilumab would be beneficial in AD.`
This article is a review of the one major clinical trial that assessed the efficacy of dupilumab in patients with AD. Its goal is to provide a comparison to the current modalities for the treatment of AD and expert insight regarding future studies.
The results of this study are a significant therapeutic advancement. Dupilumab was shown to provide a mean percent change in Eczema Area and Severity Index score of -74% ± 3.6, in addition to, statistically and clinically significant reductions the severity, symptomatology, and morbidity associated with AD. However, the small sample size makes it difficult to assess the magnitude of this effect. As a result, dupilumab will likely be reserved for cases of severe AD unresponsive to traditional modalities.
中重度特应性皮炎（AD）的现有治疗选择有限，且存在潜在的危险副作用。度普利尤单抗是一种新型单克隆抗体，最近在中重度AD成年患者中进行了研究。度普利尤单抗可抑制白细胞介素-4（IL-4）和白细胞介素-13（IL-13）信号传导，此前已发现其在哮喘治疗中有效。鉴于AD和哮喘均为Th2细胞介导的炎症过程，有理由怀疑度普利尤单抗对AD有益。
本文是对一项评估度普利尤单抗治疗AD患者疗效的主要临床试验的综述。其目的是与AD的当前治疗方式进行比较，并提供有关未来研究的专家见解。
该研究结果是一项重大的治疗进展。度普利尤单抗除了使湿疹面积和严重程度指数评分平均百分比变化达到-74%±3.6外，还在统计学和临床上显著降低了与AD相关的严重程度、症状和发病率。然而，样本量较小使得难以评估这种效应的大小。因此，度普利尤单抗可能会保留用于对传统治疗方式无反应的重度AD病例。
