A 52 weeks dupilumab treatment for moderate to severe atopic dermatitis in Korea: long-term efficacy and safety in real world

Abstract

Previously, we have reported short term effectiveness and safety of dupilumab in Korea. In this study, we are trying to report the long-term effectiveness and safety of dupilumab in Korea. Ninety-nine patients with moderate to severe AD were analyzed. They were evaluated using Eczema Area and Severity Index (EASI), Numerical Rating Scale (NRS), Patient Oriented Eczema Measure (POEM), and Dermatology Quality of Life Index (DLQI) at baseline, week 16, 32 and 52. Efficacy outcomes showed higher improvement at 52 weeks compared with 16 weeks; high percentual reductions in EASI (88.1%), peak pruritus NRS (65.6%), POEM (67.2%), and DLQI (69.0%) compared to baseline. Proportion of patients achieving EASI 75 and 90 were 90.2% and 53.7%. POEM and DLQI had high correlation with clinical measured outcomes. In the analysis for the factors affecting achievement of EASI 90, female gender (OR 2.5), eosinophilia (OR 0.2) and elevated LDH (OR 0.07) were significantly associated. Most frequent adverse events included facial erythema (19.2%) and conjunctivitis (17.2%), which were mild/moderate and resolved during treatment. In conclusion, dupilumab treatment for 52 weeks in Korean patients with moderate-to-severe AD confirmed long term effectiveness and safety.

Figure 1

The proportion of (a) EASI 75 and (b) EASI 90 at baseline, after 16, 32 and 52 weeks.

Figure 2

The correlation analysis between EASI, NRS, POEM, and DLQI at 52 weeks. All p-values less than 0.05, 0.01, or 0.001 are summarized as *, **, or ***, respectively.

Figure 3

Skin biopsys at baseline and after 16 weeks to be compared by (a, b) Hematoxylin and eosin, (c, d) Cluster of differentiation 3 (CD3), and (e, f) Ki-67. After 16 weeks, the epidermal thickness, irregular acanthosis, the expression of T cells and ki-67 expression were markedly decreased.