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Nettis E, Ferrucci SM, Ortoncelli M, Pellacani G, Foti C, Di Leo E, Patruno C, Rongioletti F, Argenziano G, Macchia L, Tavecchio S, Napolitano M, Ribero S, Bonzano L, Romita P, Di Bona D, Nisticò SP, Piras V, Calabrese G, Detoraki C, Carbonara M, Fabbrocini G. Use of Dupilumab for 543 Adult Patients with Moderate-To-Severe Atopic Dermatitis: A Multicenter, Retrospective Study. J Investig Allergol Clin Immunol 2020; 32:124-132. [PMID: 32856595 DOI: 10.18176/jiaci.0641] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Dupilumab has been demonstrated to be an effective treatment for patients with moderate-to-severe atopic dermatitis (AD) in clinical trials. However, evidence of real-world experience with dupilumab in a broader population is limited to date. METHODS Adult patients with moderate-to-severe AD, defined as an Eczema Area Severity Index (EASI) score of 24 or higher, treated with dupilumab at ten Italian academic centers, were included in the study. Physician-reported outcome measures (EASI), patient-reported outcome measures (pruritus and sleep score, Dermatology Life Quality Index, DLQI) and serological markers [immunoglobulin (Ig) E and eosinophil count] after 16 weeks were analyzed. RESULTS We enrolled 543 patients with moderate-to-severe AD. Two patients (0.4%) discontinued treatment. The median ± interquartile percentage change from baseline to 16 weeks of treatment in the EASI score was -87.5±22.0 (p<0.001). EASI-50, EASI-75 and EASI-90 response rates were 98.1%, 81.5%, and 50.8% after 16 weeks. At 16 weeks, 93.0% of the patients had achieved a 4- point or higher improvement in DLQI from baseline. During dupilumab treatment, 12.2% of the patients developed conjunctivitis, and total IgE significantly decreased (p<0.001). Interestingly, in the multivariate logistic regression model, the risk of developing dupilumab-related conjunctivitis was associated with early AD onset [OR, 2.25; 95%CI, 1.07-4.70; p=0.03] and presence of eosinophilia [OR, 1.91; 95%CI, 1.05-3.39; p=0.03]. CONCLUSION To date, this is the broadest real-life study in AD patients treated with dupilumab. We observed significant improvements induced by dupilumab in adult patients with moderate-to-severe AD, to a greater extent than those reported in clinical trials.
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Affiliation(s)
- E Nettis
- Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari - Aldo Moro, Bari, Italy
| | - S M Ferrucci
- UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M Ortoncelli
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy.,Medical Sciences Department, Dermatologic Clinic, University of Turin, Turin, Italy
| | - G Pellacani
- Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - C Foti
- Department of Biomedical Science and Human Oncology, Dermatological Clinic, University of Bari, Italy
| | - E Di Leo
- Section of Allergy and Clinical Immunology, Unit of Internal Medicine - "F. Miulli" Hospital, AcquavivadelleFonti, (BA), Italy
| | - C Patruno
- Unit of Dermatology, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - F Rongioletti
- Unit of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - G Argenziano
- Dermatology Unit, University of Campania, Naples, Italy
| | - L Macchia
- Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari - Aldo Moro, Bari, Italy
| | - S Tavecchio
- UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M Napolitano
- Department of Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - S Ribero
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy
| | - L Bonzano
- Allergology Service, AUSL Modena, Italy
| | - P Romita
- Department of Biomedical Science and Human Oncology, Dermatological Clinic, University of Bari, Italy
| | - D Di Bona
- Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari - Aldo Moro, Bari, Italy
| | - S P Nisticò
- Unit of Dermatology, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - V Piras
- Unit of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - G Calabrese
- Dermatology Unit, University of Campania, Naples, Italy
| | - C Detoraki
- Department of Internal Medicine and Clinical Pathology, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | - M Carbonara
- National Institute of Statistics (ISTAT), Bari, Italy
| | - G Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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Nettis E, Ortoncelli M, Pellacani G, Foti C, Di Leo E, Patruno C, Rongioletti F, Argenziano G, Ferrucci SM, Macchia L, Napolitano M, Ribero S, Bonzano L, Romita P, Di Bona D, Bennardo L, Piras V, Calabrese G, Tavecchio S, Detoraki C, Carbonara M, Fabbrocini G. A Multicenter Study on the Prevalence of Clinical Patterns and Clinical Phenotypes in Adult Atopic Dermatitis. J Investig Allergol Clin Immunol 2020; 30:448-450. [PMID: 32376512 DOI: 10.18176/jiaci.0519] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- E Nettis
- Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari - Aldo Moro, Bari, Italy
| | - M Ortoncelli
- Medical Sciences Department, Dermatologic Clinic, University of Turin, Turin, Italy
| | - G Pellacani
- Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - C Foti
- Department of Biomedical Science and Human Oncology, Dermatological Clinic, University of Bari, Italy
| | - E Di Leo
- Section of Allergy and Clinical Immunology, Unit of Internal Medicine-"F. Miulli" Hospital, Acquaviva delle Fonti, (BA), Italy
| | - C Patruno
- Unit of Dermatology, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - F Rongioletti
- Unit of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - G Argenziano
- Dermatology Unit, University of Campania, Naples, Italy
| | - S M Ferrucci
- UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy
| | - L Macchia
- Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari - Aldo Moro, Bari, Italy
| | - M Napolitano
- Department of Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - S Ribero
- Medical Sciences Department, Dermatologic Clinic, University of Turin, Turin, Italy
| | - L Bonzano
- Allergology Service, AUSL Modena, Italy
| | - P Romita
- Department of Biomedical Science and Human Oncology, Dermatological Clinic, University of Bari, Italy
| | - D Di Bona
- Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari - Aldo Moro, Bari, Italy
| | - L Bennardo
- Unit of Dermatology, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - V Piras
- Unit of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - G Calabrese
- Dermatology Unit, University of Campania, Naples, Italy
| | - S Tavecchio
- UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy
| | - C Detoraki
- Department of Internal Medicine and Clinical Pathology, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | - M Carbonara
- National Institute of Statistics (ISTAT), Bari, Italy
| | - G Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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