Gelato Federica, Mastorino Luca, Stepkina Ekaterina, Cavaliere Giovanni, Ribero Simone, Quaglino Pietro, Ortoncelli Michela
Dermatology Clinic, Department of Medical Sciences, University of Turin, 10126 Turin, Italy.
J Clin Med. 2023 Mar 11;12(6):2189. doi: 10.3390/jcm12062189.
Atopic dermatitis (AD) can be subclassified into the more frequent extrinsic type (EAD), with elevated serum IgE levels and frequent association with other atopic conditions, and the less frequent intrinsic type (IAD), with normal IgE levels and no history of atopy. This retrospective study has the objective to compare the efficacy of dupilumab therapy in patients with IAD versus EAD in a real-life setting. We studied a group of 360 patients treated with dupilumab for moderate-to-severe AD of whom 49 had IAD (IgE < 200 kU/L and no history of other atopic conditions) and 311 had EAD (IgE ≥ 200 kU/L and/or history of atopy). There were no statistically significant differences in the achievement of EASI75 between IAD and EAD patients either at 16, 32, or 48 weeks (61% vs. 50%; 66% vs. 60%; and 53% vs. 65%, respectively). Similarly, there were no statistically significant differences in the achievement of EASI90 or the reduction in NRSpp, NRSsd, and DLQI at each timepoint. Additionally, mean absolute eosinophils and IgE values were significantly higher in the EAD group at all timepoints. This study confirms that dupilumab, targeting the Th2 pathway, which is known to be overexpressed in all AD phenotypes, appears to be equally effective in the two populations regardless of IgE levels.
特应性皮炎（AD）可细分为更常见的外源性类型（EAD），其血清IgE水平升高且常与其他特应性疾病相关，以及较不常见的内源性类型（IAD），其IgE水平正常且无特应性病史。这项回顾性研究的目的是在实际临床环境中比较度普利尤单抗治疗IAD患者与EAD患者的疗效。我们研究了一组360例接受度普利尤单抗治疗的中重度AD患者，其中49例为IAD（IgE<200 kU/L且无其他特应性疾病病史），311例为EAD（IgE≥200 kU/L和/或有特应性病史）。在第16周、32周或48周时，IAD组和EAD组患者达到EASI75的比例无统计学显著差异（分别为61%对50%；66%对60%；53%对65%）。同样，在每个时间点，两组患者达到EASI90或NRSpp、NRSsd和DLQI降低的比例也无统计学显著差异。此外，在所有时间点，EAD组的平均绝对嗜酸性粒细胞和IgE值均显著更高。这项研究证实，针对已知在所有AD表型中均过度表达的Th2通路的度普利尤单抗，无论IgE水平如何，在这两种人群中似乎都同样有效。
