Real-World Experience and Laboratory Monitoring of Dupilumab in Patients with Moderate to Severe Atopic Dermatitis in a
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ORIGINAL RESEARCH
Real-World Experience and Laboratory Monitoring of Dupilumab in Patients with Moderate to Severe Atopic Dermatitis in a Tertiary Centre Firas Constantin Kreeshan
. Ali Al-Janabi . Richard Bruce Warren .
Hamish John Alexander Hunter
Received: October 5, 2020 Ó The Author(s) 2020
ABSTRACT Introduction: Dupilumab is a biologic therapy approved for treatment of moderate to severe atopic dermatitis (AD). Our objective was to assess the real-world effectiveness, safety and laboratory monitoring practices for dupilumab in a tertiary centre. Methods: A retrospective review of medical records of all patients receiving dupilumab between September 2017 and October 2019 was undertaken. Eczema Area and Severity Index (EASI) and Dermatology Life Quality Index (DLQI) were collected at weeks 0, 12–16 and 26–30. Data on laboratory tests undertaken for dupilumab screening and monitoring were also collected. Results: At 12–16 weeks, 58.9% and 37.3% of patients achieved C EASI 75 and C EASI 90, respectively (n = 156). Ninety-four patients underwent further analysis at weeks 26–30 with those achieving C EASI 75 increasing from Electronic supplementary material The online version of this article (https://doi.org/10.1007/s13555020-00469-6) contains supplementary material, which is available to authorised users. F. C. Kreeshan (&) A. Al-Janabi R. B. Warren H. J. A. Hunter The Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester M6 8HD, UK e-mail: [email protected]
61.7% (12–16 weeks) to 75.31%, and EASI 90 increasing from 35.8% (12–16 weeks) to 49.8%. The most common side effects were eye symptoms occurring in 43.1% of patients, with 16.3% developing conjunctivitis. The mean treatment duration was 255 days, during which an average of three sets of blood tests were performed (n = 149). Of all laboratory abnormalities recorded, 24% started after initiation of dupilumab, and 93% were classified as ‘mild’. Dupilumab was not documented as causative in any of the cases, nor was treatment stopped on account of laboratory abnormalities. Conclusion: Dupilumab provides an effective and safe treatment option for patients with AD. Clinical response continued to improve past 16 weeks in this real-world population. No laboratory abnormalities were felt to be secondary to dupilumab; screening and monitoring tests did not influence dupilumab prescribing. Keywords: Atopic dermatitis; Medical dermatology
Dupilumab;
Dermatol Ther (Heidelb)
Key Summary Points Why carry out this study? Dupilumab has been shown to be an effective treatment in large double-blind randomised placebo-controlled trials and smaller real-world studies. This study presents a tertiary centre experience on dupilumab effectiveness, safety and tolerability in a cohort of 164 patients followed over 12–30 weeks. This is the first real-world study to evaluate the laboratory safety of dupilumab. What was learned from the study? This study showed that
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