Sustained Improvements in QoL in Patients With AD Treated With Dupilumab

Prior use of systemic non-steroidal immunosuppressants (NSISS) did not affect dupilumab efficacy in adults with moderate-to-severe atopic dermatitis, according to study findings published online ahead of print in Dermatology and Therapy.

“In this analysis, dupilumab therapy (with or without concomitant topical corticosteroid therapy) resulted in rapid, consistent, and significant improvements in signs and symptoms of atopic dermatitis, as well as improvements in quality of life compared to control arms (placebo/placebo + topical corticosteroids),” researchers wrote. “Improvements were achieved by patients naïve to systemic NSISS, and also by patients with a history of use of these agents.”

The post hoc analysis encompassed four double-blind phase 3 trials involving 1553 patients randomized to placebo or dupilumab monotherapy for 16 weeks, or dupilumab with concomitant topical corticosteroids for 16 weeks or 52 weeks.

Regardless of prior treatment with NSISS, patients treated with dupilumab had significantly higher percentage reduction from baseline, compared with patients treated with placebo, on the following measures: the Eczema Area and Severity Index (EASI), SCORing Atopic Dermatitis (SCORAD), Dermatology Life Quality Index (DLQI), and Patient-Oriented Eczema Measure (POEM).

In addition, significantly more patients achieved EASI score ≤ 7, Peak Pruritus Numerical Rating Scale ≤ 4, POEM ≤ 7, and DLQI ≤ 5 by week 4 with dupilumab, regardless of NSISS history, compared with placebo.

“Taken together, these results indicate that a patient’s prior history of use of systemic NSISS does not impact the efficacy of dupilumab treatment for moderate-to-severe atopic dermatitis, supporting its use both as a systemic first-line treatment and in patients in whom systemic NSISS have been used,” researchers wrote. “Dupilumab brings a new perspective to systemic treatment of this patient population, offering the prospect of long-term control and flare prevention.”

Reference: 

Griffiths C, de Bruin-Weller M, Deleuran M, et al. Dupilumab in Adults with Moderate-to-Severe Atopic Dermatitis and Prior Use of Systemic Non-Steroidal Immunosuppressants: Analysis of Four Phase 3 Trials [published online ahead of print, 2021 Jun 18]. Dermatol Ther (Heidelb). 2021;10.1007/s13555-021-00558-0. doi:10.1007/s13555-021-00558-0