1
|
Montero-Vilchez T, Rodriguez-Pozo JA, Diaz-Calvillo P, Salazar-Nievas M, Tercedor-Sanchez J, Molina-Leyva A, Arias-Santiago S. Dupilumab Improves Skin Barrier Function in Adults with Atopic Dermatitis: A Prospective Observational Study. J Clin Med 2022; 11:3341. [PMID: 35743415 PMCID: PMC9225017 DOI: 10.3390/jcm11123341] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 02/04/2023] Open
Abstract
Epidermal barrier dysfunction plays an important role in atopic dermatitis (AD). The difficulty of objectively assessing AD severity and the introduction of new biologicals into clinical practice highlight the need to find parameters to monitor clinical outcomes. The aim of this study is to evaluate the impact of dupilumab on skin barrier function and compare it with other treatments in patients with AD. A prospective observational study was conducted in adults with AD treated with topical corticosteroids (TCS), cyclosporine, or dupilumab. The main outcome measures after 16 weeks of treatment were Eczema Area and Severity (EASI)-50 (50% improvement in EASI), and transepidermal water loss (TEWL)-50 (50% improvement in TEWL). Forty-six patients with AD were included in the study. The proportion of patients who achieved EASI-50 at week 16 was significantly higher in patients receiving dupilumab (81.8% vs. 28.6% vs. 40%, p = 0.004). In eczematous lesions, TEWL decreased in patients receiving dupilumab (31.02 vs. 12.10 g·h−1·m−2, p < 0.001) and TCS (25.30 vs. 14.88 g·h−1·m−2, p = 0.047). The proportion of patients who achieved TEWL-50 at week 16 was higher for dupilumab than for cyclosporine or TCS. Temperature only decreased in the dupilumab group. Stratum corneum hydration increased in eczematous lesions and non-involved skin only in patients with dupilumab. In conclusion, dupilumab improves skin barrier function in patients with AD better than TCS or cyclosporine, both in eczematous lesions and in non-lesioned skin.
Collapse
Affiliation(s)
- Trinidad Montero-Vilchez
- Department of Dermatology, Virgen de las Nieves University Hospital, 18012 Granada, Spain; (T.M.-V.); (J.-A.R.-P.); (P.D.-C.); (M.S.-N.); (J.T.-S.); (S.A.-S.)
- Biosanitary Institute of Granada (ibs.GRANADA), 18012 Granada, Spain
| | - Juan-Angel Rodriguez-Pozo
- Department of Dermatology, Virgen de las Nieves University Hospital, 18012 Granada, Spain; (T.M.-V.); (J.-A.R.-P.); (P.D.-C.); (M.S.-N.); (J.T.-S.); (S.A.-S.)
- Biosanitary Institute of Granada (ibs.GRANADA), 18012 Granada, Spain
| | - Pablo Diaz-Calvillo
- Department of Dermatology, Virgen de las Nieves University Hospital, 18012 Granada, Spain; (T.M.-V.); (J.-A.R.-P.); (P.D.-C.); (M.S.-N.); (J.T.-S.); (S.A.-S.)
- Biosanitary Institute of Granada (ibs.GRANADA), 18012 Granada, Spain
| | - Maria Salazar-Nievas
- Department of Dermatology, Virgen de las Nieves University Hospital, 18012 Granada, Spain; (T.M.-V.); (J.-A.R.-P.); (P.D.-C.); (M.S.-N.); (J.T.-S.); (S.A.-S.)
| | - Jesús Tercedor-Sanchez
- Department of Dermatology, Virgen de las Nieves University Hospital, 18012 Granada, Spain; (T.M.-V.); (J.-A.R.-P.); (P.D.-C.); (M.S.-N.); (J.T.-S.); (S.A.-S.)
- Biosanitary Institute of Granada (ibs.GRANADA), 18012 Granada, Spain
| | - Alejandro Molina-Leyva
- Department of Dermatology, Virgen de las Nieves University Hospital, 18012 Granada, Spain; (T.M.-V.); (J.-A.R.-P.); (P.D.-C.); (M.S.-N.); (J.T.-S.); (S.A.-S.)
- Biosanitary Institute of Granada (ibs.GRANADA), 18012 Granada, Spain
| | - Salvador Arias-Santiago
- Department of Dermatology, Virgen de las Nieves University Hospital, 18012 Granada, Spain; (T.M.-V.); (J.-A.R.-P.); (P.D.-C.); (M.S.-N.); (J.T.-S.); (S.A.-S.)
- Biosanitary Institute of Granada (ibs.GRANADA), 18012 Granada, Spain
- Cell Production and Tissue Engineering Unit, Virgen de las Nieves University Hospital, Andalusian Network of Design and Translation of Advanced Therapies, 18012 Granada, Spain
- Department of Dermatology, Faculty of Medicine, University of Granada, 18071 Granada, Spain
| |
Collapse
|
2
|
Diamanti E, Föhr J, Papageorgiou A, Herbst M, Jahn S. Immunologie in der dermatologischen Praxis – wieviel, warum, wann? AKTUELLE DERMATOLOGIE 2022. [DOI: 10.1055/a-1699-5440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
ZusammenfassungDie Haut als Grenzorgan zum Körperäußeren realisiert viele immunologische Abwehrfunktionen. Folglich sind Immunologie und Dermatologie eng miteinander verknüpft. Die Diagnostik immunologischer Hauterkrankungen und deren Immuntherapie, labormedizinische Analysen, Hyposensibilisierung – Begegnungen mit der Immunologie finden auch in einer dermatologischen Praxis im Alltag nahezu ständig statt. Ziel dieser Arbeit ist es, praxisnah aufzuzeigen, wie uns Dermatologen die Immunologie in unserer Fachdisziplin helfen kann.
Collapse
Affiliation(s)
| | - Julia Föhr
- Dermatologische Facharztpraxis Dr. Herbst & Kollegen, Darmstadt
- Klinik für Dermatologie und Allergologie, Philipps-Universität Marburg
| | | | - Matthias Herbst
- Dermatologische Facharztpraxis Dr. Herbst & Kollegen, Darmstadt
| | - Sigbert Jahn
- Dermatologische Facharztpraxis Dr. Herbst & Kollegen, Darmstadt
| |
Collapse
|
3
|
Dal Bello G, Schena D, Girolomoni G. Upadacitinib in patients with resistant atopic dermatitis: a retrospective case‐series. J Eur Acad Dermatol Venereol 2022; 36:1499-1500. [DOI: 10.1111/jdv.18139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 03/04/2022] [Accepted: 03/29/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Giacomo Dal Bello
- Section of Dermatology, Department of Medicine University of Verona 37126 Verona Italy
| | - Donatella Schena
- Section of Dermatology, Department of Medicine University of Verona 37126 Verona Italy
| | - Giampiero Girolomoni
- Section of Dermatology, Department of Medicine University of Verona 37126 Verona Italy
| |
Collapse
|