Multicenter Study

. 2021 Apr;35(4):958-964.

doi: 10.1111/jdv.17094. Epub 2021 Jan 19.

Dupilumab therapy of atopic dermatitis of the elderly: a multicentre, real-life study

C Patruno¹, M Napolitano², G Argenziano³, K Peris^{4

5}, M Ortoncelli⁶, G Girolomoni⁷, A Offidani⁸, S M Ferrucci⁹, G F Amoruso¹⁰, M Rossi¹¹, L Stingeni¹², G Malara¹³, T Grieco¹⁴, C Foti¹⁵, M Gattoni¹⁶, C Loi¹⁷, M Iannone¹⁸, M Talamonti¹⁹, G Stinco²⁰, F Rongioletti²¹, P D Pigatto²², A Cristaudo²³, E Nettis²⁴, M Corazza²⁵, F Guarneri²⁶, P Amerio²⁷, M Esposito²⁸, A Belloni Fortina²⁹, C Potenza³⁰, G Fabbrocini³¹; DADE - Dupilumab for Atopic Dermatitis of the Elderly study group

Collaborators, Affiliations

Collaborators

DADE - Dupilumab for Atopic Dermatitis of the Elderly study group:
L Angileri, T Bianchelli, A Borghi, C Buligan, G Calabrese, P Calzavara Pinton, F Caroppo, C Chello, G Dal Bello, G Damiani, M C Fargnoli, M Ferrillo, M Galluzzo, N Gori, G Gualdi, K Hansel, L Macchia, M Mariano, S P Nisticò, G Pertusi, V Piras, E Provenzano, G M Ravaioli, S Ribero, M Romanelli, P Romita, E Tolino, C Trifirò

Affiliations

¹ Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
² Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy.
³ Dermatology Unit, University of Campania, Naples, Italy.
⁴ Dermatology, University of the Sacred Heart, Rome, Italy.
⁵ Fondazione Policlinico Universitario A.Gemelli, IRCCS, Rome, Italy.
⁶ Dermatology Clinic, University of Turin, Turin, Italy.
⁷ Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy.
⁸ Dermatology Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy.
⁹ Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
¹⁰ AO Cosenza, UOC Dermatologia, Cosenza, Italy.
¹¹ UO Dermatologia, ASST Spedali Civili di Brescia, Brescia, Italy.
¹² Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy.
¹³ Struttura Complessa di Dermatologia, Grande Ospedale Metropolitano 'Bianchi Melacrino Morelli', Reggio Calabria, Italy.
¹⁴ Dermatology Unit, Sapienza University of Rome, Rome, Italy.
¹⁵ Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy.
¹⁶ Dermatologic Department, S. Andrea Hospital Vercelli, Vercelli, Italy.
¹⁷ Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
¹⁸ Department of Dermatology, University of Pisa, Pisa, Italy.
¹⁹ Dermatology Unit, Policlinico Tor Vergata, Department of Systemic Medicine, Tor Vergata University of Rome, Rome, Italy.
²⁰ Department of Medicine, Institute of Dermatology, University of Udine, Udine, Italy.
²¹ Unit of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
²² Department of Medical, Surgical and Odontoiatric Science, IRCCS Ospedale Ortopedico Galeazzi, Milano, Italy.
²³ San Gallicano Dermatologic Institute IRCCS, Rome, Italy.
²⁴ Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari - Aldo Moro, Bari, Italy.
²⁵ Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
²⁶ Department of Clinical and Experimental Medicine, Dermatology, University of Messina, Messina, Italy.
²⁷ Dermatologic Clinic, SS. Annunziata Hospital, Chieti, Italy.
²⁸ Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
²⁹ Unit of Dermatology, Department of Medicine DIMED, University of Padua, Padua, Italy.
³⁰ Dermatology Unit 'Daniele Innocenzi', Department of MEDICO-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy.
³¹ Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy.

PMID: 33332697
DOI: 10.1111/jdv.17094

Multicenter Study

Dupilumab therapy of atopic dermatitis of the elderly: a multicentre, real-life study

C Patruno et al. J Eur Acad Dermatol Venereol. 2021 Apr.

. 2021 Apr;35(4):958-964.

doi: 10.1111/jdv.17094. Epub 2021 Jan 19.

Authors

Collaborators

DADE - Dupilumab for Atopic Dermatitis of the Elderly study group:
L Angileri, T Bianchelli, A Borghi, C Buligan, G Calabrese, P Calzavara Pinton, F Caroppo, C Chello, G Dal Bello, G Damiani, M C Fargnoli, M Ferrillo, M Galluzzo, N Gori, G Gualdi, K Hansel, L Macchia, M Mariano, S P Nisticò, G Pertusi, V Piras, E Provenzano, G M Ravaioli, S Ribero, M Romanelli, P Romita, E Tolino, C Trifirò

Affiliations

¹ Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
² Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy.
³ Dermatology Unit, University of Campania, Naples, Italy.
⁴ Dermatology, University of the Sacred Heart, Rome, Italy.
⁵ Fondazione Policlinico Universitario A.Gemelli, IRCCS, Rome, Italy.
⁶ Dermatology Clinic, University of Turin, Turin, Italy.
⁷ Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy.
⁸ Dermatology Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy.
⁹ Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
¹⁰ AO Cosenza, UOC Dermatologia, Cosenza, Italy.
¹¹ UO Dermatologia, ASST Spedali Civili di Brescia, Brescia, Italy.
¹² Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy.
¹³ Struttura Complessa di Dermatologia, Grande Ospedale Metropolitano 'Bianchi Melacrino Morelli', Reggio Calabria, Italy.
¹⁴ Dermatology Unit, Sapienza University of Rome, Rome, Italy.
¹⁵ Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy.
¹⁶ Dermatologic Department, S. Andrea Hospital Vercelli, Vercelli, Italy.
¹⁷ Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
¹⁸ Department of Dermatology, University of Pisa, Pisa, Italy.
¹⁹ Dermatology Unit, Policlinico Tor Vergata, Department of Systemic Medicine, Tor Vergata University of Rome, Rome, Italy.
²⁰ Department of Medicine, Institute of Dermatology, University of Udine, Udine, Italy.
²¹ Unit of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
²² Department of Medical, Surgical and Odontoiatric Science, IRCCS Ospedale Ortopedico Galeazzi, Milano, Italy.
²³ San Gallicano Dermatologic Institute IRCCS, Rome, Italy.
²⁴ Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari - Aldo Moro, Bari, Italy.
²⁵ Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
²⁶ Department of Clinical and Experimental Medicine, Dermatology, University of Messina, Messina, Italy.
²⁷ Dermatologic Clinic, SS. Annunziata Hospital, Chieti, Italy.
²⁸ Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
²⁹ Unit of Dermatology, Department of Medicine DIMED, University of Padua, Padua, Italy.
³⁰ Dermatology Unit 'Daniele Innocenzi', Department of MEDICO-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy.
³¹ Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy.

PMID: 33332697
DOI: 10.1111/jdv.17094

Abstract

Background: Treatment of moderate-to-severe atopic dermatitis (AD) in the elderly may be challenging, due to side-effects of traditional anti-inflammatory drugs and to comorbidities often found in this age group. Furthermore, efficacy and safety of innovative drugs such as dupilumab are not yet well known.

Objectives: A multicentre retrospective, observational, real-life study on the efficacy and safety of dupilumab was conducted in a group of patients aged ≥65 years and affected by severe AD. Their main clinical features were also examined.

Methods: Data of elderly patients with severe (EASI ≥24) AD treated with dupilumab at label dosage for 16 weeks were retrospectively collected. Treatment outcome was assessed by comparing objective (EASI) and subjective (P-NRS, S-NRS and DLQI) scores at baseline and after 16 weeks of treatment.

Results: Two hundred and seventy-six patients were enrolled in the study. They represented 11.37% of all patients with severe AD. Flexural eczema was the most frequent clinical phenotype, followed by prurigo nodularis. The coexistence of more than one phenotype was found in 63/276 (22.82%) subjects. Data on the 16-week treatment with dupilumab were available for 253 (91.67%) patients. Efficacy of dupilumab was demonstrated by a significant reduction of all the scores. No statistically significant difference regarding efficacy was found in elderly patients when compared to the group of our AD patients aged 18-64 years, treated with dupilumab over the same period. Furthermore, only 18 (6.52%) patients discontinued the drug due to inefficacy. Sixty-one (22.51%) patients reported adverse events, conjunctivitis and flushing being the most frequent. One (0.36%) patient only discontinued dupilumab due to an adverse event.

Conclusions: Therapy with dupilumab led to a significant improvement of AD over a 16-week treatment period, with a good safety profile. Therefore, dupilumab could be considered as an efficacious and safe treatment for AD also in the elderly.

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References

1. Williamson S, Merritt J, De Benedetto A. Atopic dermatitis in the elderly: a review of clinical and pathophysiological hallmarks. Br J Dermatol 2020; 182: 47-54.
1. Katsarou A, Armenaka M. Atopic dermatitis in older patients: particular points. J Eur Acad Dermatol Venereol 2011; 25: 12-18.
1. Chello C, Carnicelli G, Sernicola A et al. Atopic dermatitis in the elderly Caucasian population: diagnostic clinical criteria and review of the literature. Int J Dermatol 2020; 59: 716-721.
1. Napolitano M, Fabbrocini G, Scalvenzi M, Blasio C, Stingeni L, Patruno C. Efficacy and safety of dupilumab in atopic dermatitis in elderly patients: a retrospective study. Clin Exp Dermatol 2020; 45: 888-890.
1. Ramos-e-Silva M, Boza JC, Cestari TF. Effects of age (neonates and elderly) on skin barrier function. Clin Dermatol 2012; 30: 274-276.

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Dupilumab therapy of atopic dermatitis of the elderly: a multicentre, real-life study

Collaborators

Affiliations

Dupilumab therapy of atopic dermatitis of the elderly: a multicentre, real-life study

Authors

Collaborators

Affiliations

Abstract

References

Publication types

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical