Dubini Marco, Benzecry Valentina, Rivolta Federica, Sangalli Andrea, Marzano Angelo Valerio, Pravettoni Valerio, Tavecchio Simona, Ferrucci Silvia Mariel
Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Front Allergy. 2023 Sep 11;4:1223657. doi: 10.3389/falgy.2023.1223657. eCollection 2023.
Atopic dermatitis (AD) is considered a systemic type 2 immune driven disease, and it is associated to many atopic comorbidities including asthma. The aim of our study was to prospectively evaluate the respiratory outcomes in patients with persistent allergic asthma treated with dupilumab due to severe AD (sAD).
We enrolled eligible patients with sAD for dupilumab treatment from September 2018 to December 2020. We then selected the subgroup of patients sensitized to perennial allergens. Dupilumab's efficacy and safety on AD and comorbid asthma were assessed at baseline, one month, four months, and then every 4 months up to one year.
A total of 437 patients with sAD were enrolled for dupilumab treatment due to sAD, and 273 reached 48 weeks of therapy. Respiratory outcomes were evaluated in the 85 asthmatic patients with positivity only to perennial allergens. Our patients showed statistically and clinically significant improvement in asthma control (Asthma Control Test and Asthma Control Questionnaire) and airway obstruction parameters (FEV1), in addition to the expected AD-related skin outcomes. Specifically, a significant improvement was achieved at the fourth month of dupilumab therapy, and this trend was maintained up to twelve months, regardless of asthma severity.
Our results showed the overall improvement of the clinical picture that dupilumab offers for patients with severe AD and persistent allergic asthma of any severity, highlighting the importance of a global multidisciplinary approach of type 2 driven disease.
特应性皮炎（AD）被认为是一种由2型免疫驱动的全身性疾病，它与包括哮喘在内的许多特应性合并症相关。我们研究的目的是前瞻性评估因重度AD（sAD）而接受度普利尤单抗治疗的持续性过敏性哮喘患者的呼吸结局。
我们纳入了2018年9月至2020年12月符合条件的sAD患者接受度普利尤单抗治疗。然后我们选择了对常年性过敏原致敏的患者亚组。在基线、1个月、4个月，然后每4个月直至1年，评估度普利尤单抗对AD和合并哮喘的疗效及安全性。
共有437例因sAD而接受度普利尤单抗治疗的患者入组，273例患者达到了48周的治疗。在85例仅对常年性过敏原呈阳性的哮喘患者中评估了呼吸结局。除了预期的与AD相关的皮肤结局外，我们的患者在哮喘控制（哮喘控制测试和哮喘控制问卷）和气道阻塞参数（FEV1）方面显示出统计学和临床意义上的改善。具体而言，度普利尤单抗治疗第4个月时取得了显著改善，并且这种趋势持续至12个月，无论哮喘严重程度如何。
我们的结果显示度普利尤单抗为重度AD和任何严重程度的持续性过敏性哮喘患者带来的临床情况总体改善，突出了对2型驱动疾病采用全球多学科方法的重要性。
