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度普利尤单抗和皮下免疫治疗难治性中重度特应性皮炎:初步报告。

Dupilumab and subcutaneous immunotherapy for the treatment of refractory moderate to severe atopic dermatitis: A preliminary report.

机构信息

Department of Dermatology, Southwest Hospital, Amy Medical University, Chongqing, China.

School of Medicine, Chongqing University, Chongqing 400038, China.

出版信息

Int Immunopharmacol. 2023 Dec;125(Pt A):111137. doi: 10.1016/j.intimp.2023.111137. Epub 2023 Oct 27.

Abstract

Subcutaneous immunotherapy (SCIT) and dupilumab are important treatments for patients with moderate to severe atopic dermatitis (AD). However, in clinical practice, poor response to allergen immunotherapy (AIT) or dupilumab has been observed in some patients. It is unknown whether combining dupilumab and SCIT can improve treatment responses in patients with moderate to severe AD that is resistant to dupilumab or SCIT monotherapy. This single-centre, retrospective, observational, real-world study evaluated the efficacy and safety of dupilumab and SCIT for refractory moderate to severe AD. The data of ten patients with moderate to severe atopic dermatitis who were treated with dupilumab and SCIT were retrospectively analysed. The scoring atopic dermatitis (SCORAD) score, numerical rating scale (NRS), and atopic dermatitis control test (ADCT) scores and eosinophil and total IgE levels before and after add-on therapy were compared and analysed. The SCORAD, NRS, and ADCT scores decreased significantly at four and 12 weeks after the initiation of add-on therapy and plateaued during maintenance treatment. The eosinophil and total IgE levels were not significantly different before and after add-on therapy. No serious adverse reactions were reported in any patient during add-on therapy. This study indicates that the combination of dupilumab and SCIT safely improves the treatment response of patients with moderate to severe AD who are resistant to dupilumab or SCIT monotherapy.

摘要

皮下免疫疗法 (SCIT) 和度普利尤单抗是治疗中重度特应性皮炎 (AD) 患者的重要手段。然而,在临床实践中,一些患者对过敏原免疫疗法 (AIT) 或度普利尤单抗的治疗反应不佳。目前尚不清楚在对度普利尤单抗或 SCIT 单药治疗耐药的中重度 AD 患者中,联合使用度普利尤单抗和 SCIT 是否能改善治疗反应。这项单中心、回顾性、观察性、真实世界研究评估了度普利尤单抗和 SCIT 对难治性中重度 AD 的疗效和安全性。回顾性分析了 10 例接受度普利尤单抗和 SCIT 联合治疗的中重度特应性皮炎患者的数据。比较并分析了附加治疗前后的特应性皮炎评分 (SCORAD) 评分、数字评分量表 (NRS)、特应性皮炎控制测试 (ADCT) 评分以及嗜酸性粒细胞和总 IgE 水平。附加治疗开始后 4 周和 12 周,SCORAD、NRS 和 ADCT 评分显著降低,并在维持治疗期间趋于稳定。附加治疗前后嗜酸性粒细胞和总 IgE 水平无显著差异。在附加治疗期间,没有患者报告严重不良反应。本研究表明,度普利尤单抗联合 SCIT 安全地改善了对度普利尤单抗或 SCIT 单药治疗耐药的中重度 AD 患者的治疗反应。

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