度普利尤单抗治疗老年特应性皮炎：一项多中心、真实世界研究。

Dupilumab therapy of atopic dermatitis of the elderly: a multicentre, real-life study.

作者信息

Patruno C, Napolitano M, Argenziano G, Peris K, Ortoncelli M, Girolomoni G, Offidani A, Ferrucci S M, Amoruso G F, Rossi M, Stingeni L, Malara G, Grieco T, Foti C, Gattoni M, Loi C, Iannone M, Talamonti M, Stinco G, Rongioletti F, Pigatto P D, Cristaudo A, Nettis E, Corazza M, Guarneri F, Amerio P, Esposito M, Belloni Fortina A, Potenza C, Fabbrocini G

机构信息

Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.

Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy.

出版信息

J Eur Acad Dermatol Venereol. 2021 Apr;35(4):958-964. doi: 10.1111/jdv.17094. Epub 2021 Jan 19.

DOI:10.1111/jdv.17094

PMID:33332697

Abstract

BACKGROUND

Treatment of moderate-to-severe atopic dermatitis (AD) in the elderly may be challenging, due to side-effects of traditional anti-inflammatory drugs and to comorbidities often found in this age group. Furthermore, efficacy and safety of innovative drugs such as dupilumab are not yet well known.

OBJECTIVES

A multicentre retrospective, observational, real-life study on the efficacy and safety of dupilumab was conducted in a group of patients aged ≥65 years and affected by severe AD. Their main clinical features were also examined.

METHODS

Data of elderly patients with severe (EASI ≥24) AD treated with dupilumab at label dosage for 16 weeks were retrospectively collected. Treatment outcome was assessed by comparing objective (EASI) and subjective (P-NRS, S-NRS and DLQI) scores at baseline and after 16 weeks of treatment.

RESULTS

Two hundred and seventy-six patients were enrolled in the study. They represented 11.37% of all patients with severe AD. Flexural eczema was the most frequent clinical phenotype, followed by prurigo nodularis. The coexistence of more than one phenotype was found in 63/276 (22.82%) subjects. Data on the 16-week treatment with dupilumab were available for 253 (91.67%) patients. Efficacy of dupilumab was demonstrated by a significant reduction of all the scores. No statistically significant difference regarding efficacy was found in elderly patients when compared to the group of our AD patients aged 18-64 years, treated with dupilumab over the same period. Furthermore, only 18 (6.52%) patients discontinued the drug due to inefficacy. Sixty-one (22.51%) patients reported adverse events, conjunctivitis and flushing being the most frequent. One (0.36%) patient only discontinued dupilumab due to an adverse event.

CONCLUSIONS

Therapy with dupilumab led to a significant improvement of AD over a 16-week treatment period, with a good safety profile. Therefore, dupilumab could be considered as an efficacious and safe treatment for AD also in the elderly.

摘要

背景

由于传统抗炎药物的副作用以及该年龄组中常见的合并症，老年中重度特应性皮炎（AD）的治疗可能具有挑战性。此外，诸如度普利尤单抗等创新药物的疗效和安全性尚不为人所知。

目的

对一组年龄≥65岁且患有重度AD的患者进行了一项关于度普利尤单抗疗效和安全性的多中心回顾性观察性真实世界研究。还对他们的主要临床特征进行了检查。

方法

回顾性收集了接受度普利尤单抗标准剂量治疗16周的老年重度（EASI≥24）AD患者的数据。通过比较基线时和治疗16周后的客观（EASI）和主观（P-NRS、S-NRS和DLQI）评分来评估治疗结果。

结果

276名患者纳入研究。他们占所有重度AD患者的11.37%。屈侧湿疹是最常见的临床表型，其次是结节性痒疹。63/276（22.82%）名受试者存在不止一种表型。253名（91.67%）患者有16周度普利尤单抗治疗的数据。度普利尤单抗的疗效通过所有评分的显著降低得以证明。与同期接受度普利尤单抗治疗的18-64岁AD患者组相比，老年患者在疗效方面未发现统计学上的显著差异。此外，仅18名（6.52%）患者因无效而停药。61名（22.51%）患者报告了不良事件，最常见的是结膜炎和潮红。仅1名（0.36%）患者因不良事件停用度普利尤单抗。