Mastorino Luca, Mendes-Bastos Pedro, Cavaliere Giovanni, Siliquini Niccolo, Ortoncelli Michela, Quaglino Pietro, Ribero Simone
Dermatologic Clinic, Department of Medical Sciences, University of Turin, 10121 Torino, Italy.
Dermatology Center, Hospital CUF Descobertas, 1998-018 Lisboa, Portugal.
J Clin Med. 2025 May 16;14(10):3480. doi: 10.3390/jcm14103480.
A shared definition of therapeutic targets in the treatment of atopic dermatitis (AD) allows for the identification of patients who respond rapidly (early responders [ERs]) and optimally (super responders [SRs]) to systemic treatments. A concomitant achievement of EASI75/≤7, PP-NRS ≤ 4, SCORAD-75/≤24, POEM ≤ 7, and DLQI ≤ 5 at 6 months of treatment has been defined as an ideal target for AD. Patients aged ≥ 12 years treated with dupilumab for moderate-to-severe AD in an Italian center for at least 2 years were analyzed. We defined ERs as those who achieved EASI ≤ 7, PP-NRS ≤ 4, POEM ≤ 7, and DLQI ≤ 5 within 32 weeks, and SRs and long responders (LRs) as those who maintained the target at 1 year and at 2 years, respectively. We subsequently compared baseline characteristics between those who fell within the above definitions and those who did not. : Of 171 patients with AD, 76.6% were ERs, 49.1% SRs, and 40.4% LRs. Achievement of combined outcomes was shown by 37.11% of patients at 16 weeks, and increased at the following time points by more than half of patients at 2 years of treatment. Except for a high baseline POEM that appears to be unfavorable for achieving early response (OR 0.93, CI 0.88-0.98, = 0.006), no baseline characteristics were associated with ERs, SRs, or LRs in this population. According to our definition of responders, we were unable to identify a patient profile at baseline that predicts optimal therapeutic outcomes with dupilumab. Only baseline POEM seems to affect achievement of the selected outcomes. Dupilumab showed a rapid achievement of the outcomes with a stable response after 4 months of treatment, according our definitions. Shared definitions of the different categories of patient responders and a common therapeutic target are necessary for optimal management of AD.
特应性皮炎（AD）治疗中治疗靶点的共同定义有助于识别对全身治疗反应迅速（早期反应者[ERs]）和最佳（超级反应者[SRs]）的患者。在治疗6个月时同时实现湿疹面积和严重程度指数（EASI）改善75%/≤7、医师全面评估数值评定量表（PP-NRS）≤4、特应性皮炎评分（SCORAD）改善75%/≤24、湿疹治疗疗效评估量表（POEM）≤7以及皮肤病生活质量指数（DLQI）≤5已被定义为AD的理想治疗目标。对意大利一家中心至少接受度普利尤单抗治疗2年的12岁及以上中重度AD患者进行了分析。我们将ERs定义为在32周内实现EASI≤7、PP-NRS≤4、POEM≤7以及DLQI≤5的患者，将SRs和长期反应者（LRs）分别定义为在1年和2年维持治疗目标的患者。随后，我们比较了符合上述定义的患者与不符合上述定义的患者的基线特征。在171例AD患者中，76.6%为ERs，49.1%为SRs，40.4%为LRs。16周时37.11%的患者实现了综合治疗效果，在治疗2年时超过半数患者在后续时间点实现了综合治疗效果。除了较高的基线POEM似乎不利于实现早期反应（比值比[OR]0.93，可信区间[CI]0.88 - 0.98，P = 0.
