Monoclonal Antibody Outperforms Other Treatments in Improving Skin Barrier Function

Dupilumab was better than topical corticosteroids and cyclosporine at improving skin barrier function in adults with atopic dermatitis, according to a study published in the Journal of Clinical Medicine.

“This is the first study to evaluate the impact of dupilumab on skin barrier function and compare it to other treatments,” wrote a research team from Granada, Spain.

The prospective, observational study included 46 patients with atopic dermatitis treated with topical corticosteroids, cyclosporine, or dupilumab in line with current clinical recommendations. Researchers analyzed Eczema Area and Severity (EASI)-50 (50% improvement in EASI), and transepidermal water loss (TEWL)-50 (50% improvement in TEWL) after 16 weeks of treatment.

EASI-50 at week 16 was achieved by 81.8% of patients receiving dupilumab, 40% of patients receiving topical corticosteroids, and 28.6% of patients receiving cyclosporine, according to the study.

TEWL in eczematous lesions decreased in patients receiving dupilumab and topical corticosteroids but not in patients receiving cyclosporine, researchers found. TWEL-50 at week 16 was achieved by 50% of patients receiving dupilumab, 30% of patients receiving topical corticosteroids, and 14.3% of patients receiving cyclosporine.

Additionally, temperature on eczematous lesions decreased, and stratum corneum hydration in eczematous lesions and noninvolved skin increased, only in patients receiving dupilumab, the study showed.

“Our research is limited by the small sample size and concerns surrounding data collection: in Spain, it is compulsory to use cyclosporine before dupilumab treatment, possibly biasing the comparison between patients receiving dupilumab and cyclosporine,” researchers wrote. “This bias would be toward the null hypothesis, as the real difference in skin barrier function between dupilumab and cyclosporine would be even greater than that reported in this study.”

Reference:
Montero-Vilchez T, Rodriguez-Pozo JA, Diaz-Calvillo P, et al. Dupilumab improves skin barrier function in adults with atopic dermatitis: a prospective observational study. J Clin Med. 2022;11(12):3341. doi:10.3390/jcm11123341