Dupilumab Decreases Disease Severity and Extent of Atopic Dermatitis

Close-up of atopic dermatitis on the back of the knee
Close-up of atopic dermatitis on the back of the knee
Data from 4 phase 3 trials suggest that all anatomic regions are equally responsive to dupilumab treatment in patients with moderate-to-severe atopic dermatitis.

Dupilumab is effective and safe when used to treat both exposed and unexposed anatomic regions in patients with moderate-to-severe atopic dermatitis, according to a study published in the British Journal of Dermatology.

The investigators of this study sought to examine the efficacy and safety of dupilumab to treat adults with moderate-to-severe atopic dermatitis, reporting baseline disease burden and treatment impact by specific anatomic region including exposed areas of the face, neck, and hands.

The investigators extracted data on a large cohort of adults with atopic dermatitis recruited from 4 large phase 3 trials, including 2 trials of dupilumab monotherapy (SOLO 1, ClinicalTrials.gov identifier: NCT02277743; SOLO 2, ClinicalTrials.gov identifier: NCT02277769) and 2 trials of dupilumab with concomitant topical corticosteroid use (CAFÉ, ClinicalTrials.gov identifier: NCT02755649; CHRONOS, ClinicalTrials.gov identifier: NCT02260986). Participants received 300 mg of subcutaneous dupilumab every 2 weeks, 300 mg of dupilumab every week, or a placebo. Primary outcome measures were the severity and extent of atopic dermatitis compared with placebo using the Eczema Area and Severity Index (EASI).

EASI scores for each anatomic region at baseline were comparable among all the treatment groups; the head/neck region had the lowest total score while lower extremities had the highest total score. Comparing absolute extent and severity of lesions, the head/neck region maintained the lowest EASI score while the upper extremities had the highest score.

From baseline to week 16, patients receiving dupilumab treatment showed significantly greater improvement vs placebo for all anatomic regions across all trials. Similar results were reported at week 4 across all trials and at week 52 in the CHRONOS trial.

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Adverse events were observed at similar rates across treatment groups in all trials; the most common adverse events reported were injection-site reactions and conjunctivitis.  

In patients with moderate-to-severe atopic dermatitis, dupilumab significantly improved disease severity for all anatomic regions as early as week 4. The investigators suggest that dupilumab treatment is safe and effective for both exposed and unexposed regions, with treatment response being equal in all anatomic regions.

Disclosure: This study was funded by Sanofi and Regeneron Pharmaceuticals, Inc. Multiple authors disclosed affiliations with pharmaceutical companies. See the reference for complete disclosure information.

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Blauvelt A, Rosmarin D, Bieber T, et al. Improvement of atopic dermatitis with dupilumab occurs equally well across different anatomic regions: data from phase 3 clinical trials [published online February 4, 2019]. Br J Dermatol. doi: 10.1111/bjd.17703