Wang J Y, Zhou B J, Cao Q Z, Peng C, Chen M L, Chen X, Li J
Department of Dermatology, Xiangya Hospital, Central South University Hunan Key Laboratory of Skin Cancer and Psoriasis National Clinical Research Center for Geriatric Disorders, Changsha 410008, China.
Zhonghua Yi Xue Za Zhi. 2024 Aug 6;104(30):2810-2816. doi: 10.3760/cma.j.cn112137-20240114-00104.
To analyse the efficacy and safety of dupilumab in the treatment of moderate to severe atopic dermatitis (AD). The clinical data of moderate to severe AD patients who received dupilumab therapy in the Department of Dermatology, Xiangya Hospital, Central South University from August 2020 to November 2022 were retrospectively analyzed. The efficacy was evaluated by Eczema Area and Severity Index (EASI), SCORing Atopic Dermatitis (SCORAD), Numerical Rating Scale (NRS), Patient Oriented Eczema Measure (POEM), and Dermatology Quality of Life Index (DLQI) before treatment and 2, 4, 16 and 24 weeks after treatment. Adverse events that occurred during treatment were recorded. Repeated Measures ANOVA and Generalized Estimating Equations were used to compare changes in scores and changes in laboratory indices at different time points before and after treatment. The age of 259 patients was (35.4±25.9) years, the duration of AD was 4.00 (2.00, 9.00) years, and 64.1% (166 patients) were men patients. The scores of EASI, SCORAD, POEM, DLQI and NRS at 2, 4, 16 and 24 weeks after treatment with dupilumab were significantly lower than those before treatment (all <0.001). The proportions of EASI50, EASI75, and EASI90 were 91.0% (101/111), 71.2% (79/111), and 40.5% (45/111) at 16 weeks, and 95.0% (76/80), 80.0% (64/80) and 45.0% (36/80) at 24 weeks, respectively. Basal total IgE levels (=0.005) and EOS counts (<0.001) at Week 24 were significantly lower than those before treatment. Adverse events occurred in 54 patients (20.9%), mainly manifested as intractable erythema of the face and neck (5.0%, 13 patients) and conjunctivitis (1.9%, 5 patients). Dupilumab can effectively improve the rash area, rash severity and itchiness of moderate to severe atopic dermatitis, improve the quality of life of patients, and reduce the incidence of adverse effects.
分析度普利尤单抗治疗中度至重度特应性皮炎（AD）的疗效和安全性。回顾性分析2020年8月至2022年11月在中南大学湘雅医院皮肤科接受度普利尤单抗治疗的中度至重度AD患者的临床资料。在治疗前以及治疗后2周、4周、16周和24周，通过湿疹面积和严重程度指数（EASI）、特应性皮炎评分（SCORAD）、数字评定量表（NRS）、患者导向性湿疹评估（POEM）以及皮肤病生活质量指数（DLQI）评估疗效。记录治疗期间发生的不良事件。采用重复测量方差分析和广义估计方程比较治疗前后不同时间点的评分变化和实验室指标变化。259例患者年龄为（35.4±25.9）岁，AD病程为4.00（2.00，9.00）年，男性患者占64.1%（166例）。度普利尤单抗治疗后2周、4周、16周和24周时，EASI、SCORAD、POEM、DLQI和NRS评分均显著低于治疗前（均<0.001）。16周时EASI50、EASI75和EASI90的比例分别为91.0%（101/111）、71.2%（79/111）和40.5%（45/111），24周时分别为95.0%（76/80）、80.0%（64/80）和45.0%（36/80）。第24周时基础总IgE水平（=0.005）和嗜酸性粒细胞计数（<0.001）显著低于治疗前。54例患者（20.9%）发生不良事件，主要表现为面颈部顽固性红斑（5.0%，13例）和结膜炎（1.9%，5例）。度普利尤单抗可有效改善中度至重度特应性皮炎的皮疹面积、皮疹严重程度和瘙痒程度，提高患者生活质量，并降低不良反应发生率。
