Atopic dermatitis: dupilumab effectively improves patient-reported outcomes and health-related quality of life

  • Cork MJ & al.
  • J Dermatolog Treat
  • 9 Jun 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • In patients with moderate-to-severe atopic dermatitis (AD), dupilumab is effective in improving patient-reported outcomes (PROs), including itch, sleep, pain, anxiety and depression, and health-related quality of life (HRQoL).

Why this matters

  • Moderate-to-severe AD can be challenging to treat because of the risk/benefit profiles of systemic therapies.
  • Dupilumab improves clinical outcomes, is well tolerated, and approved to treat inadequately controlled moderate-to severe AD in adults; however, its effect on PROs is not fully characterised.

Study design

  • This study included 1379 patients with AD who participated in the LIBERTY AD SOLO 1 and SOLO 2 studies and randomly assigned to receive dupilumab 300 mg every 2 weeks (q2W; n=457) and every week (n=462; qw), and placebo (n=460).
  • Peak Pruritus Numerical Rating Scale (NRS), Pruritus Categorical Scale, SCORing AD (SCORAD), Dermatology Life Quality Index (DLQI), Patient-Oriented Eczema Measure, Hospital Anxiety and Depression Scale (HADS), 5-dimension EuroQoL questionnaire (EQ-5D) and patient-assessed disease status and treatment efficacy were evaluated.
  • Funding: Sanofi and Regeneron Pharmaceuticals, Inc.

Key results

  • Dupilumab q2w and qw groups vs placebo had significant improvement in:
    • Peak Pruritus NRS scores by day 2 (least squares [LS] mean change, −4.5%; P=.0033 and −4.0%; P=.0110 vs −0.6%, respectively).
    • Anxiety and depression HADS (LS mean change, −2.9% and −3.0% vs −0.8%) and HRQoL DLQI (LS mean change, −5.6% and −5.7% vs −1.9%) by week 2 (P<.0001 for all>
  • Improvement was maintained through week 16 in both the groups (P<.0001>
  • At week 16, dupilumab q2w and qw groups vs placebo had significant improvement in:
    • SCORAD itch (LS mean change, −4.00% and −4.06% vs −1.26%) and sleep (LS mean change, −3.30% and −3.40% vs −0.82%).
    • No pain/discomfort (EQ-5D; 45.7% and 43.2% vs 13.5%; P<.0001 for all>

Limitations

  • Cultural differences of translated PROs.

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