Kim Heeyeon, Oh Sejin, Noh Hyungrye, Joo Byeonghyun, Shim Joonho, Park Jihye, Lee Dongyoun, Lee Jong Hee
Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Medical Device Management & Research, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Korea.
Ann Dermatol. 2025 Feb;37(1):39-45. doi: 10.5021/ad.24.084.
There is a growing demand for extending dosing intervals of dupilumab injections in patients with atopic dermatitis (AD) due to treatment burden and side effects. However, studies on successful dose reduction in real-world settings are lacking.
To assess the efficacy of a patient-centered dupilumab tapering regimen and to propose guidelines for target patients, appropriate intervals, and timing for tapering.
This single-center retrospective study included moderate to severe adult AD patients who underwent at least 16 weeks of dupilumab treatment. Interval prolongation was considered in controlled patients assessed by Eczema Area and Severity Index (EASI) score and serum inflammatory markers after at least 40 weeks of treatment with a standard regimen. Logistic regression model with generalized estimating equations was used to compare repetitive measurements over time between the two groups.
A total of 52 patients were included with 11 patients extending intervals to 3-4 weeks without flare-ups. The mean duration of dupilumab treatment before tapering was 53.27 weeks. The tapering group exhibited significantly lower body mass index. All patients of the tapering group showed EASI scores under 4 and immunoglobulin E (IgE) levels under 1,000 IU/mL at week 40. EASI scores and IgE levels remained consistently low after dose reduction, with a mean follow-up time of 14.36 months.
Patients with extended dosing intervals demonstrated sustained effectiveness. Dose tapering might be a valuable option for non-obese patients with positive clinical response characterized by an EASI score under 4 and IgE levels under 1,000 at week 40.
由于治疗负担和副作用，特应性皮炎（AD）患者对延长度普利尤单抗注射给药间隔的需求日益增加。然而，缺乏关于在现实环境中成功减量的研究。
评估以患者为中心的度普利尤单抗减量方案的疗效，并为目标患者、合适的间隔时间和减量时机提出指导原则。
这项单中心回顾性研究纳入了接受至少16周度普利尤单抗治疗的中度至重度成年AD患者。在采用标准方案治疗至少40周后，根据湿疹面积和严重程度指数（EASI）评分及血清炎症标志物评估病情得到控制的患者，考虑延长给药间隔。使用具有广义估计方程的逻辑回归模型比较两组随时间的重复测量结果。
共纳入52例患者，其中11例患者将给药间隔延长至3 - 4周且无病情复发。减量前度普利尤单抗治疗的平均持续时间为53.27周。减量组的体重指数显著较低。减量组所有患者在第40周时EASI评分低于4，免疫球蛋白E（IgE）水平低于1000 IU/mL。减量后EASI评分和IgE水平持续保持较低水平，平均随访时间为14.36个月。
延长给药间隔的患者显示出持续的疗效。对于在第40周时以EASI评分低于4和IgE水平低于1000为特征的具有阳性临床反应的非肥胖患者，减量可能是一个有价值的选择。
