Dupilumab Linked to Lower Hospitalization Rates for Patients with AD

Adults with moderate to severe atopic dermatitis (AD) treated with dupilumab experienced fewer all-cause and AD-related hospitalizations and shorter atopic dermatitis-related hospitalization stays compared with control patients, according to data synthesized from several phase 2 or 3 randomized controlled trials that was published in The Journal of Allergy and Clinical Immunology: In Practice.

Investigators pooled data from 7 trials comparing adults with moderate to severe AD treated with dupilumab 300 mg every 2 weeks or weekly for 12, 16, or 52 weeks, with and without topical corticosteroids, with adults receiving a placebo. Investigators stratified patients receiving dupilumab by treatment group for comparison with control patients: dupilumab weekly, dupilumab twice weekly, and all patients receiving dupilumab (“dupilumab combined”). Investigators calculated event rates as number of events per 100 patient-years (PY) for all-cause and AD-related hospitalizations and length of stay.

There were 2,932 patients included in the analysis –1,841 prescribed dupilumab and 1,091 control patients. Patients were recruited from 28 different countries. The mean age across treatment and placebo groups was about 38 years, and about 59% of all groups were men. The mean AD disease duration across all groups was around 28.4 years.

Patients in the combined dupilumab had lower rates of all-cause hospitalizations (P <.001; 62% risk reduction), AD-related hospitalizations (P <.001; 79% risk reduction), and significantly shorter duration of AD-related hospitalizations (8.6 vs 38.9 days per 100 PY; rate ratio [RR], 0.10; P =.06) compared with the control patients.

Individual dupilumab treatment groups also had significantly lower rates of all-cause (weekly dupilumab: P <.001, 71% risk reduction; every 2 weeks: P =.033, 49% risk reduction) and AD-related hospitalizations (weekly: P =.002, 91% risk reduction; every 2 weeks: P =.07, 60% risk reduction) compared with control groups. AD-related hospitalization duration was also lower by individual dupilumab groups compared to control groups.

The most common reason for hospitalization was “AD exacerbation,” which was significantly lower in the combined dupilumab group vs the control groups (0.7 vs 2.6 events per 100 PY; RR, 0.29; 95% CI, 0.11 to 0.75; P =.011; 71% risk reduction). “Skin and soft-tissue infections” was also less common in the dupilumab combined group (P =.5; 38% risk reduction) vs the control groups.

The study was limited by external generalization of the analyses which were based on data from RCTs, it was allowed.

The study authors noted that the reduced rate of all-cause hospitalizations associated with dupilumab treatment, although not necessarily shedding light on treatment efficacy for AD, “provides additional information relevant to the safety profile of dupilumab.”

Disclosure: Several study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Silverberg JI, Rubini NPM, Pires MC, et al. Dupilumab treatment reduces hospitalizations in adults with moderate-to-severe atopic dermatitis. J Allergy Clin Immunol Pract. Published online January 12, 2022. doi:10.1016/j.jaip.2021.11.034