Ferrucci Silvia, Casazza Giovanni, Angileri Luisa, Tavecchio Simona, Germiniasi Francesca, Berti Emilio, Marzano Angelo Valerio, Genovese Giovanni
UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università degli Studi di Milano, 20157 Milan, Italy.
J Clin Med. 2020 Mar 13;9(3):791. doi: 10.3390/jcm9030791.
Dupilumab is an anti-interleukin-4 receptor monoclonal antibody that was recently approved for the treatment of atopic dermatitis (AD). In this single-center retrospective study, clinical baseline data of 117 severe AD patients treated with dupilumab were collected. At baseline and at weeks 4 and 16, disease severity was assessed through the Eczema Area and Severity Index (EASI) and quality of life through the Dermatology Life Quality Index (DLQI) questionnaire, Patient-Oriented Eczema Measure (POEM), Hospital Anxiety and Depression Scale (HADS), Peak Pruritus Numerical Rating Scale (NRS-itch), and VAS-sleep. Response to dupilumab was defined as an improvement of ≥75% in EASI from baseline (EASI75). At multivariate analysis, AD onset before 18 years [OR, 2.9; 95% CI, 1.2-7.2; = 0.0207] and absence of hypereosinophilia [OR, 2.24; 95% CI, 1.03-4.86; = 0.0412] were identified as significant predictive parameters for response to dupilumab in terms of EASI75 at week 4 but not at week 16. Significant reductions in EASI, DLQI, POEM, HADS, NRS-itch, and VAS-sleep were found between week 4 versus baseline ( < 0.0001 for all) and week 16 versus baseline ( < 0.0001 for all). Early AD onset and absence of hypereosinophilia may be suggested as predictive markers of early response to dupilumab. We confirmed the efficacy and safety of this agent along with the improvement of life quality in severe AD patients.
度普利尤单抗是一种抗白细胞介素-4受体单克隆抗体，最近被批准用于治疗特应性皮炎（AD）。在这项单中心回顾性研究中，收集了117例接受度普利尤单抗治疗的重度AD患者的临床基线数据。在基线以及第4周和第16周时，通过湿疹面积和严重程度指数（EASI）评估疾病严重程度，通过皮肤病生活质量指数（DLQI）问卷、患者导向性湿疹评估量表（POEM）、医院焦虑抑郁量表（HADS）、瘙痒峰值数字评定量表（NRS-瘙痒）和视觉模拟评分法（VAS-睡眠）评估生活质量。度普利尤单抗的反应定义为EASI较基线改善≥75%（EASI75）。在多变量分析中，18岁之前发病的AD[比值比（OR），2.9；95%置信区间（CI），1.2 - 7.2；P = 0.0207]和无嗜酸性粒细胞增多症[OR，2.24；95%CI，1.03 - 4.86；P = 0.0412]被确定为第4周而非第16周时EASI75方面对度普利尤单抗反应的显著预测参数。在第4周与基线相比（所有P均<0.0001）以及第16周与基线相比（所有P均<0.0001）时，EASI、DLQI、POEM、HADS、NRS-瘙痒和VAS-睡眠均有显著降低。早期AD发病和无嗜酸性粒细胞增多症可能被认为是对度普利尤单抗早期反应的预测标志物。我们证实了该药物在重度AD患者中的疗效和安全性以及生活质量的改善。
