Severe atopic dermatitis: Dupilumab is not just safer, but more efficient

Main Article Content

Mara Giavina-Bianchi
Luiz Vicente Rizzo
Pedro Giavina-Bianchi

Keywords

Eczema, atopic, Eczema, infantile, Neurodermatitis, atopic, Neurodermatitis, disseminated, Dupilumab, Immunosuppressive drugs.

Abstract

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by relapsing eczema and pruritus. Until the development of Dupilumab, a new monoclonal antibody targeting IL-4 and IL-13 receptors, the current treatment of severe cases was based on immunosuppressant agents. Our main goal was to build a case series of five patients with severe atopic dermatitis, who were using immunosuppressive drugs with significant adverse effects and only partially controlled AD, and compare their symptoms, SCORAD index, treatment regimens, total and specific IgE, and blood cell count before and after the introduction of Dupilumab. SCORAD index and topical corticosteroids used on a daily basis had a significant decrease after 16 weeks of Dupilumab. Adverse effects were mild: conjunctivitis, local reaction and regional dermatosis. All patients with severe atopic dermatitis achieved better control of AD with Dupilumab than with immunosuppressive drugs. Adverse effects, secondary infections, total and specific IgE levels were greatly reduced.

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References

[1]. Silverberg JI, Hanifin JM. Adult eczema prevalence and associations with asthma and other health and demographic factors: a US population-based study. J Allergy Clin Immunol. 2013;132(5):1132-8.

[2]. Bieber T. Atopic dermatitis. N Engl J Med. 2008;358(14):1483-94.

[3]. Wollenberg A, Barbarot S, Bieber T, et al. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part II. J Eur Acad Dermatol Venereol. 2018;32(6):850-78.

[4]. Simpson EL, Akinlade B, Ardeleanu M. Two Phase 3 Trials of Dupilumab versus Placebo in Atopic Dermatitis. N Engl J Med. 2017;376(11):1090-1.

[5]. Faiz S, Giovannelli J, Podevin C, Jachiet M, Bouaziz JD, Reguiai Z, et al. Effectiveness and safety of dupilumab for the treatment of atopic dermatitis in a real-life French multicenter adult cohort. J Am Acad Dermatol. 2019;81(1):143-51.

[6]. Agnihotri G, Shi K, Lio PA. A Clinician’s Guide to the Recognition and Management of Dupilumab-Associated Conjunctivitis. Drugs R D. 2019;19(4):311-8.

[7]. Zhu GA, Chen JK, Chiou A, Ko J, Honari G. Assessment of the development of new regional dermatoses in patients treated for atopic dermatitis with Dupilumab. JAMA Dermatol. 2019;155(7):850-2.