Background: Atopic dermatitis (AD) profoundly impacts patients’ lives, necessitating long-term systemic treatments. Methods: This retrospective study involved 709 severe AD patients receiving dupilumab. Drug survival (DS) was analyzed using Kaplan-Meier curves, evaluating reasons for discontinuation. The log-rank test and Cox regression analysis were applied to assess differences in drug survival across baseline clinical characteristic groups. Results: Dupilumab showcased remarkable overall drug survival, reaching 74.1% at 65 months. Survival rates remained robust even when considering discontinuation solely due to primary or secondary inefficacy (86.4% at 65 months). For overall DS, the log-rank test did not reveal a statistically significant difference among the groups. Cox regression analysis showed that patients with nummular eczema-like as a phenotype have an increased risk of discontinuing dupilumab due to the development of psoriasis (p <.001, hazard ratio = 26.15, confidence interval [CI] 6.903–99.016). The multivariate logistic regression analysis confirmed these results (p <.001, OD = 18.956, CI 4.205–85.458), even when considering other clinical and epidemiological characteristics. Conclusion: This investigation establishes dupilumab’s enduring efficacy and safety in severe AD, emphasizing its potential as a sustained therapeutic option over 5+ years. Baseline characteristics did not seem to influence DS, with the exception of the nummular eczema-like phenotype, which emerged as a significant predictor of psoriasis occurrence.

Five-year real-world drug survival of dupilumab in severe atopic dermatitis and associate predictors / F. Barei, P. Calzari, L. Valtellini, A. Chiei Gallo, G. Perego, S. Tavecchio, M. Zussino, A.V. Marzano, S. Ferrucci. - In: THE JOURNAL OF DERMATOLOGICAL TREATMENT. - ISSN 0954-6634. - 35:1(2024), pp. 2404718.1-2404718.8. [10.1080/09546634.2024.2404718]

Five-year real-world drug survival of dupilumab in severe atopic dermatitis and associate predictors

F. Barei
;
P. Calzari;L. Valtellini;A. Chiei Gallo;G. Perego;S. Tavecchio;M. Zussino;A.V. Marzano
Penultimo
;
2024

Abstract

Background: Atopic dermatitis (AD) profoundly impacts patients’ lives, necessitating long-term systemic treatments. Methods: This retrospective study involved 709 severe AD patients receiving dupilumab. Drug survival (DS) was analyzed using Kaplan-Meier curves, evaluating reasons for discontinuation. The log-rank test and Cox regression analysis were applied to assess differences in drug survival across baseline clinical characteristic groups. Results: Dupilumab showcased remarkable overall drug survival, reaching 74.1% at 65 months. Survival rates remained robust even when considering discontinuation solely due to primary or secondary inefficacy (86.4% at 65 months). For overall DS, the log-rank test did not reveal a statistically significant difference among the groups. Cox regression analysis showed that patients with nummular eczema-like as a phenotype have an increased risk of discontinuing dupilumab due to the development of psoriasis (p <.001, hazard ratio = 26.15, confidence interval [CI] 6.903–99.016). The multivariate logistic regression analysis confirmed these results (p <.001, OD = 18.956, CI 4.205–85.458), even when considering other clinical and epidemiological characteristics. Conclusion: This investigation establishes dupilumab’s enduring efficacy and safety in severe AD, emphasizing its potential as a sustained therapeutic option over 5+ years. Baseline characteristics did not seem to influence DS, with the exception of the nummular eczema-like phenotype, which emerged as a significant predictor of psoriasis occurrence.
Atopic dermatitis; associate predictors; drug-survival; dupilumab; nummular eczema; psoriasiform dermatitis; psoriasis
Settore MEDS-10/C - Malattie cutanee e veneree
2024
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/1135138
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