Dupilumab rapidly improves treatment outcomes in erythrodermic atopic dermatitis

Erythrodermic AD is a severe subtype of AD which is characterized by extensive skin involvement. The condition is complicated and requires hospitalization.

Researchers assessed the safety and efficacy of Dupilumab in such patients. The present study (post hoc analysis) included 209 patients with erythrodermic AD in 6 trials receiving dupilumab treatment vs placebo. These patients had AD affected 90 % of body surface area (BSA).

Dupilumab was given once weekly or every two weeks.

The primary outcomes and measures of the study included efficacy (BSA, EASI, PP-NRS score), serum biomarker changes and safety at week 16.

The results of the study could be summarised as follows:

• Out of 3075 patients, 209 met the criteria for erythrodermic AD.
• The median age in monotherapy and concomitant TCS trials was 31 and 39 years, respectively.
• In erythrodermic AD patients, dupilumab once weekly and every two weeks vs placebo significantly the improved percentage of BSA affected by AD with monotherapy −42.0% and −39.9% vs −17.2% and concomitant TCS −63.2% and −56.1% vs −14.5%.
• The values of EASI score with monotherapy −58.5% and −58.3% vs −22.3% , concomitant TCS −78.9% and −70.6% vs 19.3% , PP-NRS score in monotherapy −45.9% and −33.9% vs −0.6% and concomitant therapy −53.0% and −55.7% vs −26.0%.
• There was significant improvement seen as early as week 1.
• There were significantly reduced Biomarker levels vs placebo.
• Reaction at the injection site, conjunctivitis, and nasopharyngitis was seen in patients treated with dupilumab.

To conclude, dupilumab results in rapid and sustained improvements in AD patients and has a good safety profile.

Further reading:

JAMA Dermatol. Paller AS et al. Efficacy and Safety of Dupilumab in Patients With Erythrodermic Atopic Dermatitis: A Post Hoc Analysis of 6 Randomized Clinical Trials. Published online February 01, 2023. doi:10.1001/jamadermatol.2022.6192