Yang Chin-Yi, Lai Po-Ju, Chen Chun-Bing, Chan Tom C, Hui Rosaline Chung-Yee, Huang Yu-Huei, Tseng Han-Chi, Lin Shang-Hung, Lu Chun-Wei, Lee Hua-En, Lin Jing-Yi, Chi Min-Hui, Tsai Ming-Feng, Hwang Yih-Shiou, Wang Chuang-Wei, Chu Chia-Yu, Chung Wen-Hung
Department of Dermatology, New Taipei Municipal TuCheng Hospital, New Taipei City 236, Taiwan.
Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.
J Clin Med. 2022 Oct 21;11(20):6209. doi: 10.3390/jcm11206209.
To determine phenotype-related dupilumab response in adult patients with atopic dermatitis (AD), this multicenter, retrospective study included 111 adults with moderate-to-severe AD in Taiwan, with median age of 31.5 years (18-87) and 71 (64.0%) males. Patients received dupilumab 300 mg per two to three weeks up to 12 months. We found a significant improvement after 4 and 16 weeks of treatment in all patients for all the assessed scores, including eczema area and severity index (EASI) improvement ≥50% (EASI-50) and 75% (EASI-75), EASI reaching minimal clinically important difference (MCID), and Investigator's Global Assessment (IGA) improvement ≥2. Importantly, prior to asthma, early AD onset and 3-week drug intervals were significantly associated with a high proportion of EASI-75 at month 12, while prurigo and lichenoid phenotypes were associated with a lower proportion of EASI-75 at month 12. However, the majority of adverse events were mild in severity. In conclusion, our study results identify phenotype-related dupilumab response at month 12 in adults with moderate-to-severe AD, and we suggest that treatment should not be discontinued until reaching a satisfactory clinical response.
为了确定成年特应性皮炎(AD)患者中与表型相关的度普利尤单抗反应,这项多中心回顾性研究纳入了台湾111例中重度AD成年患者,中位年龄为31.5岁(18 - 87岁),男性71例(64.0%)。患者每两至三周接受一次300 mg度普利尤单抗治疗,最长治疗12个月。我们发现,在治疗4周和16周后,所有患者所有评估分数均有显著改善,包括湿疹面积和严重程度指数(EASI)改善≥50%(EASI - 50)和75%(EASI - 75)、EASI达到最小临床重要差异(MCID)以及研究者整体评估(IGA)改善≥2级。重要的是,在哮喘之前,AD早期发病和3周的药物间隔与12个月时高比例的EASI - 75显著相关,而痒疹和苔藓样表型与12个月时较低比例的EASI - 75相关。然而,大多数不良事件的严重程度为轻度。总之,我们的研究结果确定了中重度AD成年患者在12个月时与表型相关的度普利尤单抗反应,并且我们建议在达到满意的临床反应之前不应停止治疗。