Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
Mt Sinai Health System, New York, New York.
Ann Allergy Asthma Immunol. 2021 Jan;126(1):40-45. doi: 10.1016/j.anai.2020.07.026. Epub 2020 Jul 31.
The real-world persistence with dupilumab therapy for atopic dermatitis (AD) is unknown.
To characterize adults with AD who initiated dupilumab and evaluate persistence with dupilumab therapy.
This retrospective cohort study used the IBM MarketScan Commercial and Medicare database. Adults with AD who initiated dupilumab (first dispensation = index date) between March 28, 2017, and March 31, 2018, were identified and followed up until September 30, 2018, or disenrollment. Twelve months of continuous preindex enrollment were required to characterize baseline treatment history and comorbidities. Kaplan-Meier analysis was used to estimate dupilumab persistence at 6 and 12 months, assuming a 14-day injection frequency and a 30-day grace period.
A total of 1963 adults were identified who initiated dupilumab (mean [SD] age 42.1 [15.7] years; 50.7% women; 49.8% with ≥1 atopic comorbidity). Baseline AD treatments included topical corticosteroids (81.6%), systemic corticosteroids (72.5%), and systemic immunosuppressants (22.8%). Dupilumab persistence (95% confidence interval) at 6 and 12 months was 91.9% (90.7%-93.2%) and 77.3% (75.0%-79.7%), respectively. Among 329 patients who discontinued dupilumab, the risk of reinitiation was 78.8% (95% confidence interval: 75.8%-81.7%) within an average of 4 months.
Dupilumab persistence at 12 months was high, suggesting patient satisfaction with effectiveness, tolerability, and treatment regimen.
特应性皮炎（AD）患者实际应用度普利尤单抗治疗的持续性情况尚不清楚。
描述接受度普利尤单抗治疗的 AD 成人患者，并评估其对度普利尤单抗治疗的持续性。
本回顾性队列研究使用了 IBM MarketScan 商业和医疗保险数据库。2017 年 3 月 28 日至 2018 年 3 月 31 日期间首次使用度普利尤单抗（首次配药=索引日期）的 AD 成人患者被识别出来，并随访至 2018 年 9 月 30 日或退出研究。需要满足 12 个月的连续预索引入组，以描述基线治疗史和合并症。采用 Kaplan-Meier 分析估计度普利尤单抗在 6 个月和 12 个月时的持续性，假设注射频率为 14 天，宽限期为 30 天。
共确定了 1963 名开始使用度普利尤单抗的成年人（平均[标准差]年龄 42.1[15.7]岁；50.7%为女性；49.8%有≥1 种特应性合并症）。基线 AD 治疗包括局部皮质类固醇（81.6%）、全身皮质类固醇（72.5%）和全身免疫抑制剂（22.8%）。度普利尤单抗在 6 个月和 12 个月时的持续性（95%置信区间）分别为 91.9%（90.7%-93.2%）和 77.3%（75.0%-79.7%）。在 329 名停用度普利尤单抗的患者中，平均 4 个月内再次开始使用度普利尤单抗的风险为 78.8%（95%置信区间：75.8%-81.7%）。
12 个月时度普利尤单抗的持续性较高，表明患者对其疗效、耐受性和治疗方案满意。
