Fifty‐two week follow‐up safety and effectiveness results of dupilumab treatment of moderate‐to‐severe atopic dermatitis from a retrospective, multicentric series

2019 ◽  
pp. e12931 ◽  
Author(s):  
Ricardo Ruiz‐Villaverde ◽  
Javier Dominguez‐Cruz ◽  
Jose Carlos Armario‐Hita ◽  
Leandro Martinez‐Pilar ◽  
Sara Alcantara‐Luna ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Severe Atopic Dermatitis

scholarly journals Weight gain in patients with severe atopic dermatitis treated with dupilumab: a case series

2020 ◽  
Author(s):  
Emma Kristin Johansson ◽  
Lina Ulrika Ivert ◽  
Baltzar Bradley ◽  
Maria Lundqvist ◽  
Maria Bradley
Keyword(s):  
Atopic Dermatitis ◽  
Weight Gain ◽  
Weight Change ◽  
Rating Scale ◽  
Case Series ◽  
Interleukin 4 ◽  
Rank Test ◽  
Severe Atopic Dermatitis ◽  
Night Sleep

Abstract Background Dupilumab, targeting the interleukin-4α receptor and inhibiting the action of interleukin-4 and interleukin-13, was recently approved for treatment of moderate to severe atopic dermatitis. There is limited data on long-term effects and safety among patients with severe atopic dermatitis treated with dupilumab. Weight gain was observed among patients treated with dupilumab in our clinic. The aim was to describe weight change in a case series of patients with severe atopic dermatitis treated with dupilumab from baseline to follow-up after 12 months, and to analyze if weight change was associated with effect of treatment, reported appetite, and/or disturbed night sleep due to itching. Methods All patients with atopic dermatitis receiving systemic treatment at the Unit of Dermatology, Karolinska University Hospital, have been registered and monitored consecutively since January 2017. This case series constituted all patients who started treatment on dupilumab or methotrexate between 10 January 2017 and 30 June 2019 with at least 6 months of follow-up within the study period. The following variables were monitored at start of and during treatment: Eczema Severity Score Index, Patient-Oriented Eczema Measure, visual analogue scale for pruritus 10cm, Montgomery-Åsberg Depression Rating Scale, Dermatology Life Quality Index, and weight. Data analyses were performed using two-sample Wilcoxon-Mann-Whitney rank-sum test, or the Wilcoxon matched-pairs sign-rank test with a p-value <0.05 considered as statistically significant. Results Patients treated with dupilumab (n=12) gained weight (mean 6.1 kg, range [0.1–18.0], p=0.002) after one year on treatment. The majority of patients showed a good response to treatment with dupilumab (n=11); at follow-up at 6, 9, or 12 months, they reached EASI-90 (n=6), EASI-75 (n=4), or EASI-50 (n=1). There was no significant association between weight gain and treatment response, reported appetite, or disturbed night-sleep due to itch. Patients treated with methotrexate showed no significant weight change (n=8). Conclusions To our knowledge, this is the first report on a possible association between weight gain and dupilumab treatment; the extent of the association is yet to be seen, as is the mechanism behind this finding.

scholarly journals Weight gain in patients with severe atopic dermatitis treated with dupilumab: a cohort study

2020 ◽  
Author(s):  
Emma Kristin Johansson ◽  
Lina Ulrika Ivert ◽  
Baltzar Bradley ◽  
Maria Lundqvist ◽  
Maria Bradley
Keyword(s):  
Atopic Dermatitis ◽  
Cohort Study ◽  
Weight Gain ◽  
Weight Change ◽  
Rating Scale ◽  
Interleukin 4 ◽  
Rank Test ◽  
Severe Atopic Dermatitis ◽  
Night Sleep

Abstract Background Dupilumab, targeting the interleukin-4α receptor and inhibiting the action of interleukin-4 and interleukin-13, was recently approved for treatment of moderate to severe atopic dermatitis. There is limited data on long-term effects and safety among patients with severe atopic dermatitis treated with dupilumab. Weight gain was observed among patients treated with dupilumab in our clinic. The aim was to describe weight change in a cohort study of patients with severe atopic dermatitis treated with dupilumab from baseline to follow-up after 12 months, and to analyze if weight change was associated with effect of treatment, reported appetite, and/or disturbed night sleep due to itching.Methods All patients with atopic dermatitis receiving systemic treatment at the Unit of Dermatology, Karolinska University Hospital, have been registered and monitored consecutively since January 2017. This cohort constituted all patients who started treatment on dupilumab or methotrexate between 10 January 2017 and 30 June 2019 with at least 6 months of follow-up within the study period. The following variables were monitored at start of and during treatment: Eczema Severity Score Index, Patient-Oriented Eczema Measure, visual analogue scale for pruritus 10cm, Montgomery-Åsberg Depression Rating Scale, Dermatology Life Quality Index, and weight. Data analyses were performed using two-sample Wilcoxon-Mann-Whitney rank-sum test, or the Wilcoxon matched-pairs sign-rank test with a p-value <0.05 considered as statistically significant.Results Patients treated with dupilumab (n=12) gained weight (mean 6.1 kg, range [0.1–18.0], p=0.002) after one year on treatment. The majority of patients showed a good response to treatment with dupilumab (n=11); at follow-up at 6, 9, or 12 months, they reached EASI-90 (n=6), EASI-75 (n=4), or EASI-50 (n=1). There was no significant association between weight gain and treatment response, reported appetite, or disturbed night-sleep due to itch. Patients treated with methotrexate showed no significant weight change (n=8). Conclusions To our knowledge, this is the first report on a possible association between weight gain and dupilumab treatment; the extent of the association is yet to be seen, as is the mechanism behind this finding.

scholarly journals An 8-Year-Old Child with Delayed Diagnosis of Netherton Syndrome

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Alexander K. C. Leung ◽  
Benjamin Barankin ◽  
Kin Fon Leong
Keyword(s):  
Atopic Dermatitis ◽  
Early Diagnosis ◽  
Marked Improvement ◽  
Low Dose ◽  
Delayed Diagnosis ◽  
Severe Atopic Dermatitis ◽  
Netherton Syndrome

We report an 8-year-old boy with Netherton syndrome who was misdiagnosed and treated as severe atopic dermatitis. The diagnosis of Netherton syndrome was not made until the child was 8 years of age. We discuss the pitfalls in the diagnosis and alert physicians to the proper and early diagnosis of this syndrome. The child was treated with a low dose (0.25 mg/kg) of oral acitretin and a topical moisturizer with marked improvement of his skin and pruritus in 2 months. At 6-month follow-up, the skin was almost clear of erythema and scaling, and the hair was longer and stronger. The dose of acitretin was reduced to 0.12 mg/kg for another 6 months and then discontinued.

A Short Cycle of Narrow-Band UVB Phototherapy in the Early Phase of Dupilumab Therapy Can Provide a Quicker Improvement of Severe Atopic Dermatitis

Dermatology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Mariateresa Rossi ◽  
Chiara Rovati ◽  
Mariachiara Arisi ◽  
Cesare Tomasi ◽  
Irene Calzavara-Pinton ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Narrow Band ◽  
Ultraviolet B ◽  
Adult Patients ◽  
Severe Atopic Dermatitis ◽  
Treatment Regimens ◽  
Short Course ◽  
Receive Treatment ◽  
Uvb Phototherapy

<b><i>Background:</i></b> Since the best clinical response to dupilumab is achieved after 12–16 weeks, a combination therapy at the beginning of the treatment could be a helpful strategy to reach a faster response in patients with severe atopic dermatitis (AD). <b><i>Objectives:</i></b> To quantify the benefit of a combination of dupilumab treatment with a short course of narrow-band ultraviolet B (NB-UVB) phototherapy. <b><i>Methods:</i></b> In the present pilot study adult patients suffering from severe AD were enrolled with a 2:1 ratio to receive treatment with dupilumab alone or dupilumab plus NB-UVB phototherapy, for 12 weeks. After the twelfth week, all patients received dupilumab only. A follow-up visit took place after 16 weeks. Both clinician-oriented and patient-oriented scores were assessed at baseline (T0) and after 4 (T1), 12 (T2) and 16 (T3) weeks. <b><i>Results:</i></b> Forty-five adult patients were enrolled in the study. Both treatment regimens were well tolerated and very effective on all measured scores (EASI, SCORAD, BSA, NRS of itching, NRS of sleep loss, DLQI, POEM and HADS), but the combined regimen led to a more robust clinical improvement of lesions and relief of symptoms after 4 weeks. However, after 12 and 16 weeks, the additional therapeutic effect of phototherapy weakened. <b><i>Conclusion:</i></b> NB-UVB phototherapy can provide a faster remission of severe AD in the first few weeks of dupilumab therapy.

scholarly journals Treatment of Severe Atopic Dermatitis with Cyclosporine: A Review of Eight Patients

2013 ◽  
Vol 5 (1) ◽  
pp. 13-20
Author(s):  
Lidija Kandolf Sekulović ◽  
Kristina Kostić ◽  
Željko Mijušković ◽  
Miroslav Dinić ◽  
Lidija Cvetković Jordanov ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Atopic Dermatitis ◽  
Case Series ◽  
Skin Lesions ◽  
Severe Atopic Dermatitis ◽  
Military Medical Academy ◽  
Systemic Corticosteroids ◽  
Medical Academy ◽  
The Military

Abstract Atopic dermatitis is most frequently well controlled with topical therapeutic agents, but based on several studies, 10-20% of patients need systemic therapy. The most common systemic treatment for atopic dermatitis in everyday practice includes systemic corticosteroids, although there are insufficient valid data to support this. Cyclosporine is the treatment of choice for severe atopic dermatitis resistant to other commonly used treatment options, since its favorable therapeutic risk/benefit ratio is well documented in randomized placebo controlled trials, and also in uncontrolled trials. However, approximately 10% of patients with atopic dermatitis with indication for cyclosporine treatment are actually treated with this modality in Serbia, and there are no published case series on its use in this region so far. In this article, we evaluated the treatment efficacy and safety of cyclosporine microemulsion in patients with severe atopic dermatitis hospitalized at the Military Medical Academy in Belgrade from 2009 to 2012. This restrospective analysis included patients with severe forms of atopic dermatitis treated at the Department of Dermatology of the Military Medical Academy from 2009 - 2012. The hospital database was used to retrieve patients’ medical records. Approximately 200 patients were treated for atopic dermatitis and 20 patients were admitted to the hospital, 17 due to severe forms of disease. In total, 8 of 17 (47.05%) hospitalized patients with severe forms or erythroderma due to atopic dermatitis were treated with cyclosporine microemulsion with an initial dose of 4-5 mg/kg. Laboratory tests were done before treatment, 7 days later, and/or at the end of hospitalization. Therapeutic efficacy was evaluated based on the percentage of reduction of skin lesions from baseline to the end of hospital treatment (early efficacy), and at the end of follow-up (late efficacy). Duration of therapy, adverse events, treatment efficacy and reasons for treatment cessation were recorded during the follow-up period. There were five male and 3 female patients, with an average age of 36.8 years (15 - 60 years). Previous treatment modalities in all patients included emollients, topical and systemic corticosteroids and PUVA therapy. The average dose of cyclosporine was 4.5±0,5 mg/kg. Median reduction of skin lesions at discharge was 60%. There was no need for further hospitalization after an average of 10±3.2 days. Mean duration of treatment was 16 months (3 - 24), with an average reduction of skin lesions of 75% during follow-up. Arterial blood pressure increased in 3/8 (37.5%) patients, regardless of their age, with and average increase of systolic blood pressure of 11.9±11.6 mm Hg (median 7.5, 0-30 mm Hg) and diastolic blood pressure of 5.6±12.9 mm Hg (median 0, -10-20). Mean increase in urea concentration was 0.3 mmol/L (11.8%) and creatinine increased only in three patients by 4.2% (median increase 4 mmol/L). Hypertension was found in three patients during follow-up, and there were no other adverse events. In conclusion, based on previous studies and this small case series of hospitalized patients with severe forms of atopic dermatitis including erythroderma, cyclosporine can be regarded as a safe and effective treatment modality and it can be recommended as first line therapy in severe forms of atopic dermatitis refractory to topical therapy and phototherapy. Long term therapy, however, should be avoided and a maximum 1-2 year therapy is recommended.

scholarly journals Weight gain in patients with severe atopic dermatitis treated with dupilumab: a cohort study

2020 ◽  
Author(s):  
Emma Kristin Johansson ◽  
Lina Ulrika Ivert ◽  
Baltzar Bradley ◽  
Maria Lundqvist ◽  
Maria Bradley
Keyword(s):  
Atopic Dermatitis ◽  
Cohort Study ◽  
Weight Gain ◽  
Weight Change ◽  
Rating Scale ◽  
Interleukin 4 ◽  
Rank Test ◽  
Severe Atopic Dermatitis ◽  
Night Sleep

Abstract Background Dupilumab, targeting the interleukin-4α receptor and inhibiting the action of interleukin-4 and interleukin-13, was recently approved for treatment of moderate to severe atopic dermatitis. There is limited data on long-term effects and safety among patients with severe atopic dermatitis treated with dupilumab. Weight gain was observed among patients treated with dupilumab in our clinic. The aim was to describe weight change in a cohort study of patients with severe atopic dermatitis treated with dupilumab from baseline to follow-up after 12 months, and to analyze if weight change was associated with effect of treatment, reported appetite, and/or disturbed night sleep due to itching.Methods All patients with atopic dermatitis receiving systemic treatment at the Unit of Dermatology, Karolinska University Hospital, have been registered and monitored consecutively since January 2017. This cohort constituted all patients who started treatment on dupilumab or methotrexate between 10 January 2017 and 30 June 2019 with at least 6 months of follow-up within the study period. The following variables were monitored at start of and during treatment: Eczema Severity Score Index, Patient-Oriented Eczema Measure, visual analogue scale for pruritus 10cm, Montgomery-Åsberg Depression Rating Scale, Dermatology Life Quality Index, and weight. Data analyses were performed using two-sample Wilcoxon-Mann-Whitney rank-sum test, or the Wilcoxon matched-pairs sign-rank test with a p-value <0.05 considered as statistically significant.Results Patients treated with dupilumab (n=12) gained weight (mean 6.1 kg, range [0.1–18.0], p=0.002) after one year on treatment. The majority of patients showed a good response to treatment with dupilumab (n=11); at follow-up at 6, 9, or 12 months, they reached EASI-90 (n=6), EASI-75 (n=4), or EASI-50 (n=1). There was no significant association between weight gain and treatment response, reported appetite, or disturbed night-sleep due to itch. Patients treated with methotrexate showed no significant weight change (n=8). Conclusions To our knowledge, this is the first report on a possible association between weight gain and dupilumab treatment; the extent of the association is yet to be seen, as is the mechanism behind this finding.

Safety and efficacy of dupilumab in a patient with severe atopic dermatitis and HIV infection, with 15 months of follow‐up

2020 ◽  
Vol 45 (6) ◽  
pp. 762-763
Author(s):  
M. Romagnuolo ◽  
L. Angileri ◽  
S. Tavecchio ◽  
A. V. Marzano ◽  
S. Ferrucci
Keyword(s):  
Atopic Dermatitis ◽  
Hiv Infection ◽  
Severe Atopic Dermatitis ◽  
Safety And Efficacy

scholarly journals Weight gain in patients with severe atopic dermatitis treated with dupilumab: a cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Emma Kristin Johansson ◽  
Lina Ulrika Ivert ◽  
Baltzar Bradley ◽  
Maria Lundqvist ◽  
Maria Bradley
Keyword(s):  
Atopic Dermatitis ◽  
Cohort Study ◽  
Weight Gain ◽  
Weight Change ◽  
Rating Scale ◽  
Interleukin 4 ◽  
Rank Test ◽  
Severe Atopic Dermatitis ◽  
Night Sleep

Abstract Background Dupilumab, targeting the interleukin-4α receptor and inhibiting the action of interleukin-4 and interleukin-13, was recently approved for treatment of moderate to severe atopic dermatitis. There is limited data on long-term effects and safety among patients with severe atopic dermatitis treated with dupilumab. Weight gain was observed among patients treated with dupilumab in our clinic. The aim was to describe weight change in a cohort study of patients with severe atopic dermatitis treated with dupilumab from baseline to follow-up after 12 months, and to analyze if weight change was associated with effect of treatment, reported appetite, and/or disturbed night sleep due to itching. Methods All patients with atopic dermatitis receiving systemic treatment at the Unit of Dermatology, Karolinska University Hospital, have been registered and monitored consecutively since January 2017. This cohort constituted all patients who started treatment on dupilumab or methotrexate between 10 January 2017 and 30 June 2019 with at least 6 months of follow-up within the study period. The following variables were monitored at start of and during treatment: Eczema Severity Score Index, Patient-Oriented Eczema Measure, visual analogue scale for pruritus 10 cm, Montgomery-Åsberg Depression Rating Scale, Dermatology Life Quality Index, and weight. Data analyses were performed using two-sample Wilcoxon-Mann-Whitney rank-sum test, or the Wilcoxon matched-pairs sign-rank test with a p-value < 0.05 considered as statistically significant. Results Patients treated with dupilumab (n = 12) gained weight (mean 6.1 kg, range [0.1–18.0], p = 0.002) after 1 year on treatment. The majority of patients showed a good response to treatment with dupilumab (n = 11); at follow-up at 6, 9, or 12 months, they reached EASI-90 (n = 6), EASI-75 (n = 4), or EASI-50 (n = 1). There was no significant association between weight gain and treatment response, reported appetite, or disturbed night-sleep due to itch. Patients treated with methotrexate showed no significant weight change (n = 8). Conclusions To our knowledge, this is the first report on a possible association between weight gain and dupilumab treatment; the extent of the association is yet to be seen, as is the mechanism behind this finding.

Personalized treatment of severe atopic dermatitis in a child: A 10-year follow-up

2017 ◽  
Vol 28 (7) ◽  
pp. 701-703 ◽  
Author(s):  
Simona Barni ◽  
Francesca Mori ◽  
Barbara Bortone ◽  
Elio Novembre
Keyword(s):  
Atopic Dermatitis ◽  
Personalized Treatment ◽  
Severe Atopic Dermatitis
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