Use of dupilumab in a patient with atopic dermatitis, severe asthma, and HIV infection

2020 ◽  
Vol 33 (6) ◽  
Author(s):  
Petra Brodska ◽  
Petr Panzner ◽  
Dalibor Sedlacek ◽  
Milan Terl ◽  
Petra Cetkovska
Keyword(s):  
Atopic Dermatitis ◽  
Hiv Infection ◽  
Severe Asthma

scholarly journals Characterization of severe asthma in the pediatric population

2021 ◽  
Vol 49 (2) ◽  
pp. 60-65
Author(s):  
Amalui Vasquez Perez ◽  
Anna Bobé Pol ◽  
Elizabeth Rua Hernandez ◽  
Marc García Lorenzo ◽  
Alba Gomez Serra ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Lung Function ◽  
Severe Asthma ◽  
Hospital Admissions ◽  
Age Of Onset ◽  
Pediatric Population ◽  
Heavy Traffic ◽  
Control Device ◽  
Predictive Index ◽  
Medical Histories

Introduction and objectives: Relationship between the causal mechanisms of pediatric severe asthma and severity of symptoms would be helpful for developing personalized strategies for treatment and prevention.Materials and methods: For this study, 698 medical histories of asthmatics between 6 and 18 years of age were reviewed in a period of 2 years. Variables analyzed were: age, sex, ethnicity, perinatological history, allergy history, asthma predictive index (API), exposure to tobacco, heavy traffic or epithelium, lung function, age of onset of symptoms, hospitalization admissions/PICU, systemic corticosteroids, daily symptoms control, device prescribe for daily control, and adherence.Results: A total of 86 children with severe asthma were included (12.3%). Mean age 13.3 +/− 1.86 years, sex ratio1:1, mean age of symptom onset 2.765 +/− 3.06 years, mean IgE 1076.18KU / L +/− 1136, mean eosinophils 604c / mcl +/− 511.9, mean of FEV1 93.15% +/− 16.3. Evidently, 70 children (81.4%) had positive API, 68 (79.1%) rhinitis, 34 (39.5%) atopic dermatitis. 73 (83.9%) sensitized to inhalants and 56 (65.1%) to dermatophagoides, 39 (45.3%) passive smokers, 19 (22.1%) exposure to heavy traffic; 55 (64%) showed symptoms with exercise, 35 (40.7%) had audible wheezing. The mean systemic corticosteroid cycles/year was 3.63 +/− 3.23, mean PICU admissions 0.36 +/− 0.83, mean hospital admissions 4.31 +/− 5.3, average emergency room visits/year 19.44 +/− 16.28. 38 (56.7%) had good adherence, 44 (51%) used an MDI device and 39 (45.3%) used dry powder.Conclusions: Children with severe asthma meet the following criteria: premature, positive API, rhinitis, atopic dermatitis, high IgE, eosinophilia, passive smokers, exposure to heavy traffic, decreased lung function, and low adherence to controller medication.

scholarly journals Influence of dupilumab on the economic burden of severe asthma and atopic dermatitis

2020 ◽  
pp. 15-26
Author(s):  
I. S. Krysanov ◽  
V. S. Krysanova ◽  
O. I. Karpov ◽  
V. Yu. Ermakova
Keyword(s):  
Atopic Dermatitis ◽  
Severe Asthma ◽  
Economic Burden ◽  
Weighted Average ◽  
Indirect Costs ◽  
Current Treatment ◽  
Severe Atopic Dermatitis ◽  
Local Conditions ◽  
Economic Burden Of Disease

The prevalence of comorbidity — asthma and atopic dermatitis — is not understood well yet. More severe processes decreasing quality of life and increasing a social-economic burden of disease are occurred in such kind comorbidity.Aim: an evaluation of economic burden of non-control severe asthma in combination with severe atopic dermatitis in the local conditions.Materials and methods. Analysis has been performed for adult patients; the bottom-up approach of costs evaluation was used. Direct medical and non-medical as well as indirect costs were calculated for two models: Model 1 — current practice of the treatment, Model 2 — treatment with Dupilumab. Results. Model 1 — Weighted average expenditures for one patient were 3,1 mln RUR, indirect costs were dominated (76 % from the total), severe atopic dermatitis had 15 % of total. Model 2 (with Dupilumab) — Dupilumab has decreased the total weighted average cost on 903 905 RUR. The total economic burden of comorbidity was 17,6 bln RUR in the current treatment option, and 12,4 bln RUR in Dupilumab hand (different is 5,2 bln RUR, or burden decrease is expected on 29,2 %).Conclusion. The wider introduction of Dupilumab into clinical practice, which allows achieving control in the treatment of severe asthma and severe atopic dermatitis, should reduce treatment costs and reduce the socio-economic burden of these diseases as a result.

HIV Infection and Atopic Dermatitis

2014 ◽  
pp. 341-350
Author(s):  
Adam Friedman ◽  
Donald Rudikoff ◽  
Francis Iacobellis
Keyword(s):  
Atopic Dermatitis ◽  
Hiv Infection

scholarly journals Early responders within seven days of dupilumab treatment for severe asthma evaluated by patient-reported outcome: a pilot study

2021 ◽  
Vol 16 ◽  
Author(s):  
Nozomi Tani ◽  
Nobutaka Kataoka ◽  
Yusuke Kunimatsu ◽  
Yusuke Tachibana ◽  
Takumi Sugimoto ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Severe Asthma ◽  
Early Response ◽  
Patient Reported Outcome ◽  
Forced Expiratory Volume ◽  
Response To Treatment ◽  
Severe Atopic Dermatitis ◽  
Asthma Control Test ◽  
Rapid Improvement ◽  
Patient Reported

Background: The management of severe asthma-associated symptoms is essential since they are distressing to the affected patients, and also greatly impair their quality of life. Dupilumab, a monoclonal antibody, blocks interleukin (IL)-4 and IL-13 signaling, both of which are crucial in acquired and innate immunity pathways through fast signal transduction, leading to an early response to treatment. Although rapid improvement within 1–3 days after dupilumab treatment was observed in moderate-to-severe atopic dermatitis, an early response within 7 days of dupilumab treatment in severe asthma has not been reported. Methods: Twelve consecutive patients with severe asthma who were newly treated with dupilumab between July 2019 and April 2020 were retrospectively investigated. We evaluated the early response (within 7 days) of patients with severe asthma receiving dupilumab therapy. Asthma control test (ACT) and the daily ACT, which was modified from the ACT to evaluate daily symptoms associated with asthma, were adopted as patient-reported outcomes (PROs) at week 8 and within 7 days, respectively. Patients were stratified into early responders (7 days), late responders (week 8), and non-responders without significant improvement in PROs. Descriptive statistics were adopted due to the limited number of patients.Results: Four of these 12 patients were early responders, with the following baseline characteristics: body mass index, <25 kg/m2; without depression; baseline forced expiratory volume in 1 second, <1.50 L; and more than one exacerbation in 1 year. On the other hand, five were late responders, and 44.4% of the nine responders were early responders. The higher the eosinophilic count and/or FeNO did not show any relationship between the early responder and nonresponder.Conclusions: The effect of dupilumab on severe asthma in patients with atopic features could be started earlier than 2 weeks, similar to atopic dermatitis. Daily ACT may be useful in monitoring the early efficacy of dupilumab in treating severe asthma.

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 Effectiveness of omalizumab in a patient with severe asthma and atopic dermatitis

2016 ◽  
Vol 69 (2) ◽  
Author(s):  
C. Incorvaia ◽  
C. Pravettoni ◽  
M. Mauro ◽  
M.-R. Yacoub ◽  
F. Tarantini ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Severe Asthma ◽  
Skin Disorder ◽  
Maximum Level ◽  
Rapid Improvement ◽  
Standard Drug ◽  
Progressive Decline ◽  
Conventional Drug ◽  
Economic Balance ◽  
Multiple Drugs

The anti-IgE antibody omalizumab is currently indicated in severe asthma not controlled by standard drug therapy. Recently, new indications for omalizumab were suggested, which include atopic dermatitis (AD), a skin disorder characterized by elevated levels of IgE. We report the case of a 39-year old woman with severe asthma and severe AD, both resistant to conventional drug treatment. The patient had a IgE level of 1304 kU/L, which exceeded the recommended maximum level for treating asthma with omalizumab (stated in 700 Ku/L) but was far lower than previously reported in cases of AD treated with anti-IgE. The treatment consisted of a dose of omalizumab 375 mg every two weeks, and induced a rapid improvement of asthma, with no need of other drugs after three months, along with a progressive decline of severity of AD, which after five months was completely cured. These findings suggest the usefulness of omalizumab in patients with concomitant severe asthma and AD, also considering the pharmaco-economic balance obtained by withdrawing the multiple drugs used to treat both diseases.

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