Multicenter Study

. 2022 Aug;36(8):1292-1299.

doi: 10.1111/jdv.18141. Epub 2022 Apr 22.

Moderate-to-severe atopic dermatitis in adolescents treated with dupilumab: A multicentre Italian real-world experience

L Stingeni¹, L Bianchi¹, E Antonelli¹, E S Caroppo¹, S M Ferrucci², M Ortoncelli³, G Fabbrocini⁴, E Nettis⁵, D Schena⁶, M Napolitano⁷, M Gola⁸, L Bonzano⁹, M Rossi¹⁰, A Belloni Fortina¹¹, A Balato¹², K Peris¹³, C Foti¹⁴, F Guarneri¹⁵, M Romanelli¹⁶, C Patruno¹⁷, P Savoia¹⁸, M C Fargnoli¹⁹, F Russo²⁰, E Errichetti²¹, T Bianchelli²², L Bianchi²³, G Pellacani²⁴, C Feliciani²⁵, A Offidani²⁶, M Corazza²⁷, G Micali²⁸, N Milanesi²⁹, G Malara³⁰, A Chiricozzi¹³, M Tramontana¹, K Hansel¹; DADA - Dupilumab for Atopic Dermatitis of the Adolescence Study Group

Collaborators, Affiliations

Collaborators

DADA - Dupilumab for Atopic Dermatitis of the Adolescence Study Group:
Vittorio Bini, Cinzia Buligan, Francesca Caroppo, Giacomo Dal Bello, Stefano Dastoli, Eugenia Veronica Di Brizzi, Maria Beatrice De Felici Del Giudice, Laura Diluvio, Maria Esposito, Alessandra Gelmetti, Alfredo Giacchetti, Teresa Grieco, Michela Iannone, Luigi Macchia, Rossella Marietti, Maria Letizia Musumeci, Francesca Peccerillo, Francesco Pluchino, Giulia Radi, Simone Ribero, Paolo Romita, Simona Tavecchio, Greta Tronconi, Federica Veronese

Affiliations

¹ Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
² Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
³ Division of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy.
⁴ Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
⁵ Department of Emergency and Organ Transplantation, Allergology and Clinical Immunology, University of Bari, Bari, Italy.
⁶ Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy.
⁷ Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy.
⁸ Unit of Allergological and Pediatric Dermatology, Department of Health Sciences, University of Florence, Florence, Italy.
⁹ Dermatology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy.
¹⁰ Department of Dermatology, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy.
¹¹ Unit of Dermatology, Department of Medicine DIMED, University of Padua, Padua, Italy.
¹² Unit of Dermatology, University of Campania Luigi Vanvitelli, Naples, Italy.
¹³ Institute of Dermatology, Catholic University, Rome, Italy.
¹⁴ Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy.
¹⁵ Section of Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
¹⁶ Dermatology Unit, University of Pisa, Pisa, Italy.
¹⁷ Section of Dermatology, Health Sciences Department, Magna Graecia University, Catanzaro, Italy.
¹⁸ Dermatology Clinic, Department of Health Science, University of Eastern Piedmont, Novara, Italy.
¹⁹ Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
²⁰ Section of Dermatology, Department of Clinical, Surgical Medicine and Neuroscience, University of Siena, Siena, Italy.
²¹ Institute of Dermatology, Department of Medicine (DAME), University of Udine, Udine, Italy.
²² Dermatology Unit, Istituto Nazionale di Riposo e Cura per Anziani, INRCA-IRCCS Hospital, Ancona, Italy.
²³ Dermatology Unit, System Medicine Department, University of Tor Vergata, Rome, Italy.
²⁴ Department of Dermatology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
²⁵ Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy.
²⁶ Dermatology Clinic, Clinical and Molecular Science Department, Polytechnic Marche University, Ancona, Italy.
²⁷ Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
²⁸ Dermatology Clinic, University of Catania, Catania, Italy.
²⁹ Allergological and Occupational Dermatology Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
³⁰ Dermatology Unit, Grande Ospedale Metropolitano, Reggio Calabria, Italy.

PMID: 35412683
PMCID: PMC9542087
DOI: 10.1111/jdv.18141

Multicenter Study

Moderate-to-severe atopic dermatitis in adolescents treated with dupilumab: A multicentre Italian real-world experience

L Stingeni et al. J Eur Acad Dermatol Venereol. 2022 Aug.

. 2022 Aug;36(8):1292-1299.

doi: 10.1111/jdv.18141. Epub 2022 Apr 22.

Authors

Collaborators

DADA - Dupilumab for Atopic Dermatitis of the Adolescence Study Group:
Vittorio Bini, Cinzia Buligan, Francesca Caroppo, Giacomo Dal Bello, Stefano Dastoli, Eugenia Veronica Di Brizzi, Maria Beatrice De Felici Del Giudice, Laura Diluvio, Maria Esposito, Alessandra Gelmetti, Alfredo Giacchetti, Teresa Grieco, Michela Iannone, Luigi Macchia, Rossella Marietti, Maria Letizia Musumeci, Francesca Peccerillo, Francesco Pluchino, Giulia Radi, Simone Ribero, Paolo Romita, Simona Tavecchio, Greta Tronconi, Federica Veronese

Affiliations

¹ Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
² Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
³ Division of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy.
⁴ Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
⁵ Department of Emergency and Organ Transplantation, Allergology and Clinical Immunology, University of Bari, Bari, Italy.
⁶ Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy.
⁷ Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy.
⁸ Unit of Allergological and Pediatric Dermatology, Department of Health Sciences, University of Florence, Florence, Italy.
⁹ Dermatology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy.
¹⁰ Department of Dermatology, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy.
¹¹ Unit of Dermatology, Department of Medicine DIMED, University of Padua, Padua, Italy.
¹² Unit of Dermatology, University of Campania Luigi Vanvitelli, Naples, Italy.
¹³ Institute of Dermatology, Catholic University, Rome, Italy.
¹⁴ Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy.
¹⁵ Section of Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
¹⁶ Dermatology Unit, University of Pisa, Pisa, Italy.
¹⁷ Section of Dermatology, Health Sciences Department, Magna Graecia University, Catanzaro, Italy.
¹⁸ Dermatology Clinic, Department of Health Science, University of Eastern Piedmont, Novara, Italy.
¹⁹ Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
²⁰ Section of Dermatology, Department of Clinical, Surgical Medicine and Neuroscience, University of Siena, Siena, Italy.
²¹ Institute of Dermatology, Department of Medicine (DAME), University of Udine, Udine, Italy.
²² Dermatology Unit, Istituto Nazionale di Riposo e Cura per Anziani, INRCA-IRCCS Hospital, Ancona, Italy.
²³ Dermatology Unit, System Medicine Department, University of Tor Vergata, Rome, Italy.
²⁴ Department of Dermatology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
²⁵ Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy.
²⁶ Dermatology Clinic, Clinical and Molecular Science Department, Polytechnic Marche University, Ancona, Italy.
²⁷ Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
²⁸ Dermatology Clinic, University of Catania, Catania, Italy.
²⁹ Allergological and Occupational Dermatology Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
³⁰ Dermatology Unit, Grande Ospedale Metropolitano, Reggio Calabria, Italy.

PMID: 35412683
PMCID: PMC9542087
DOI: 10.1111/jdv.18141

Abstract

Background: Moderate-to-severe atopic dermatitis (AD) in the adolescence is a high burden disease, and its treatment can be very challenging due to paucity of approved systemic drugs for this age and their side-effects. Dupilumab was recently approved for treatment of adolescent AD.

Objectives: A multicentre, prospective, real-world study on the effectiveness and safety of dupilumab in adolescents (aged from ≥12 to <18 years) with moderate-to-severe AD was conducted. The main AD clinical phenotypes were also examined.

Methods: Data of adolescents with moderate-to-severe AD treated with dupilumab at label dosage for 16 weeks were collected. Treatment outcome was assessed by EASI, NRS itch, NRS sleep loss and CDLQI scores at baseline and after 16 weeks of treatment. The clinical scores were also evaluated according to clinical phenotypes.

Results: One hundred and thirty-nine adolescents were enrolled in the study. Flexural eczema and head and neck eczema were the most frequent clinical phenotypes, followed by hand eczema and portrait-like dermatitis. Coexistence of more than 1 phenotype was documented in 126/139 (88.5%) adolescents. Three patients (2.1%) contracted asymptomatic SARS-CoV-2 infection and 1 of the discontinued dupilumab treatment before the target treatment period. A significant improvement in EASI, NRS itch, NRS sleep loss and CDLQI was observed after 16 weeks of treatment with dupilumab. This outcome was better than that observed in clinical trials. Dupilumab resulted effective in all AD phenotypes, especially in diffuse eczema. Twenty-eight (20.1%) patients reported adverse events, conjunctivitis and flushing being the most frequent. None of patients discontinued dupilumab due to adverse event.

Conclusions: Dupilumab in adolescent AD showed excellent effectiveness at week 16 with consistent improvement of all clinical scores. Moreover, dupilumab showed a good safety profile also in this COVID-19 pandemic era.

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Figures

**Figure 1**
Distribution of atopic dermatitis phenotypes in 139 adolescents.

**Figure 2**
Atopic dermatitis outcome in 138 patients at Week 16 of therapy with dupilumab according to the 7 most frequent clinical phenotypes.

See this image and copyright information in PMC

References

1. Patrick GJ, Archer NK, Miller LS. Which way do we go? Complex interactions in atopic dermatitis pathogenesis. J Invest Dermatol 2021; 141: 274–284. - PMC - PubMed
1. Silverberg JI, Barbarot S, Gadkari A et al. Atopic dermatitis in the pediatric population: a cross‐sectional, international epidemiologic study. Ann Allergy Asthma Immunol 2021; 126: 417–428. - PubMed
1. Barbarot S, Auziere S, Gadkari A et al. Epidemiology of atopic dermatitis in adults: results from an international survey. Allergy 2018; 73: 1284–1293. - PubMed
1. Patruno C, Napolitano M, Argenziano G et al. Dupilumab therapy of atopic dermatitis of the elderly: a multicentre, real‐life study. J Eur Acad Dermatol Venereol 2021; 35: 958–964. - PubMed
1. Abuabara K, Yu AM, Okhovat JP, Allen IE, Langan SM. The prevalence of atopic dermatitis beyond childhood: a systematic review and meta‐analysis of longitudinal studies. Allergy 2018; 73: 696–704. - PMC - PubMed

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Moderate-to-severe atopic dermatitis in adolescents treated with dupilumab: A multicentre Italian real-world experience

Collaborators

Affiliations

Moderate-to-severe atopic dermatitis in adolescents treated with dupilumab: A multicentre Italian real-world experience

Authors

Collaborators

Affiliations

Abstract

Figures

References

Publication types

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical

Research Materials

Miscellaneous