Department of Dermatology, Oregon Health & Science University, Portland, Oregon.
The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
J Am Acad Dermatol. 2024 Jun;90(6):1190-1199. doi: 10.1016/j.jaad.2023.12.066. Epub 2024 Feb 1.
Despite high disease burden, systemic treatment options for patients with atopic hand and/or foot dermatitis (H/F AD) are limited.
To evaluate efficacy and safety of dupilumab in H/F AD using specific instruments for assessing disease severity on hands and feet.
In this multicenter phase 3 trial, adults and adolescents with moderate-to-severe H/F AD were randomized to dupilumab monotherapy (regimen approved for generalized AD), or matched placebo. The primary endpoint was proportion of patients achieving Hand and Foot Investigator's Global Assessment score 0 or 1 at week 16. Secondary prespecified endpoints assessed the severity and extent of signs, symptom intensity (itch, pain), quality of life, and sleep.
A total of 133 patients (adults = 106, adolescents = 27) were randomized to dupilumab (n = 67) or placebo (n = 66). At week 16, significantly more patients receiving dupilumab (n = 27) than placebo (n = 11) achieved Hand and Foot Investigator's Global Assessment score 0 or 1 (40.3% vs 16.7%; P = .003). All other prespecified endpoints were met. Safety was consistent with the known AD dupilumab profile.
Short-term, 16-week treatment period.
Dupilumab monotherapy resulted in significant improvements across different domains of H/F AD with acceptable safety, supporting dupilumab as a systemic treatment approach for this often difficult to treat condition.
尽管疾病负担高,但特应性手和/或足皮炎(H/F AD)患者的系统治疗选择有限。
使用评估手部和足部疾病严重程度的特定工具评估度普利尤单抗治疗 H/F AD 的疗效和安全性。
在这项多中心 3 期试验中,中度至重度 H/F AD 患者被随机分配接受度普利尤单抗单药治疗(批准用于全身性 AD 的方案)或匹配的安慰剂。主要终点是在第 16 周达到 Hand and Foot Investigator's Global Assessment 评分 0 或 1 的患者比例。次要预设终点评估了体征的严重程度和范围、症状强度(瘙痒、疼痛)、生活质量和睡眠。
共有 133 名患者(成人 106 名,青少年 27 名)被随机分配接受度普利尤单抗(n = 67)或安慰剂(n = 66)。在第 16 周,接受度普利尤单抗治疗的患者(n = 27)比安慰剂组(n = 11)达到 Hand and Foot Investigator's Global Assessment 评分 0 或 1 的比例显著更高(40.3% vs 16.7%;P =.003)。所有其他预设终点均得到满足。安全性与已知的 AD 度普利尤单抗特征一致。
短期,16 周治疗期。
度普利尤单抗单药治疗可显著改善 H/F AD 的不同领域,安全性可接受,支持将度普利尤单抗作为治疗这种治疗困难的疾病的一种系统治疗方法。