Beyrouti Alexandre, Deuze Juliette, Fontas Eric, Foureau Aurore, Barbarot Sébastien, Aubert Hélène, Bernier Claire, Le Moigne Marie, Passeron Thierry, Boukari Feriel, Garnier Margaux, Jachiet Marie, Tetart Florence, Seneschal Julien, Toussaint Clémentine, Mahé Emmanuel, Leleu Camille, Regnault Marie Masson, Pasteur Justine, Nosbaum Audrey, Badaoui Antoine, Fougerousse Anne-Claire, Pralong Pauline, Viguier Manuelle, Droitcourt Catherine, Abasq Claire, Mallet Stéphanie, Raison-Peyron Nadia, Staumont-Sallé Delphine, Hubiche Thomas
Department of Dermatology, University Hospital of Nice, Côte d'Azur University, Nice, France.
Department of Dermatology-Venerology, Centre Hospitalier Universitaire Lille, U1286 Inserm INFINITE, Université de Lille, Lille, France.
J Allergy Clin Immunol Pract. 2025 Feb;13(2):353-360. doi: 10.1016/j.jaip.2024.12.001. Epub 2024 Dec 12.
Patients with atopic dermatitis (AD) may discontinue dupilumab owing to dupilumab-induced ocular adverse events (DOAEs) or dupilumab-induced facial redness (DFR).
To evaluate DOAE and DFR outcomes after switching to tralokinumab or Janus kinase inhibitor (JAKi).
This retrospective study included 106 patients discontinuing dupilumab because of DOAEs and/or DFR. The primary outcome was the proportion of patients with resolution of adverse events or improvement between dupilumab discontinuation (M0) and 3 to 6 months of tralokinumab or JAKi (M3-M6) treatment; the secondary outcome was the percentage of patients with controlled AD defined by Investigator's Global Assessment scores of 0/1 at M3 to M6.
Proportions of patients with DOAE (92% vs 72%; P = .0244) and DFR (85% vs 33%; P = .0006) resolution or improvement were higher with JAKi than with tralokinumab. Proportions of patients reaching an Investigator's Global Assessment score of 0/1 increased from M0-M3 through M6 (22% vs 42%; P = .0067) in the JAKi group and remained similar (32% vs 35%) in the tralokinumab group. However, 57% discontinued the new treatment after 8 months on average, mainly owing to lack of efficacy.
Janus kinase inhibitor appears to be more efficient than tralokinumab in managing dupilumab-induced AE; however, both strategies may fail to control AD.
患有特应性皮炎（AD）的患者可能会因度普利尤单抗引起的眼部不良事件（DOAE）或度普利尤单抗引起的面部发红（DFR）而停用度普利尤单抗。
评估改用曲罗芦单抗或 Janus 激酶抑制剂（JAKi）后的 DOAE 和 DFR 结果。
这项回顾性研究纳入了 106 例因 DOAE 和/或 DFR 而停用度普利尤单抗的患者。主要结局是不良事件缓解或在停用度普利尤单抗（M0）至曲罗芦单抗或 JAKi 治疗 3 至 6 个月（M3 - M6）期间改善的患者比例；次要结局是在 M3 至 M6 时根据研究者整体评估评分为 0/1 定义的 AD 得到控制的患者百分比。
JAKi 组中 DOAE（92% 对 72%；P = 0.0244）和 DFR（85% 对 33%；P = 0.0006）缓解或改善的患者比例高于曲罗芦单抗组。JAKi 组中达到研究者整体评估评分 0/1 的患者比例从 M0 - M3 到 M6 有所增加（22% 对 42%；P = 0.0067），而曲罗芦单抗组则保持相似（32% 对 35%）。然而，平均 8 个月后有 57% 的患者停用了新治疗，主要原因是缺乏疗效。
在处理度普利尤单抗引起的不良事件方面，Janus 激酶抑制剂似乎比曲罗芦单抗更有效；然而，两种策略都可能无法控制 AD。
