One-year real-world clinical effectiveness, safety, and laboratory safety of dupilumab in Japanese adult patients with atopic dermatitis: A single-center retrospective study

To the Editor: Dupilumab has demonstrated good efficacy and tolerable safety in adult patients with moderate to severe atopic dermatitis long term clinical trials,1Deleuran M. Thaci D. Beck L.A. et al.Dupilumab shows long-term enrolled a phase 3 open-label extension study.J Am Acad Dermatol. 2020; 82: 377-388Abstract Full Text PDF PubMed Scopus (89) Google Scholar but real-world data are limited. The Asian phenotype differs from European American by demonstrating increased T helper cell type 17 polarization addition 2 skewing,2Noda S. Suarez-Farinas Ungar B. al.The combines features of psoriasis TH17 polarization.J Allergy Clin Immunol. 2015; 136: 1254-1264Abstract (307) suggesting difference responsiveness dupilumab. We analyzed our 1-year actual on Japanese treated All who initiated dupilumab June 2018 August 2019 were for more than months at hospital as December 1, 2019, included this study. is approved Japan only refractory topical corticosteroid or tacrolimus 6 months. Detailed inclusion criteria, dosage, administration have been described previously.3Uchida H. Kamata Mizukawa I. al.Real-world effectiveness treatment patients: single-centre retrospective study.Br J 2019; 181: 1083-1085Crossref (25) Patients whose laboratory results not their chart excluded. Dermatologists department performed all assessments collected patient data. Sixty-one (51 men 10 women) Their mean age was 37.7 years (range 17-61 years). Only 1 received any form systemic therapy (cyclosporine) before initiating baseline Eczema Area Severity Index score 32.7 (standard deviation 11.5). Table I summarizes demographics characteristics patients. In patients, skin eruption improved greatly after initiation Fig percentage changes these parameters compared respective values. total significantly decreased 47.1% month, 70.4% months, 75.6% 76.5% 12 Other severity scores quality-of-life 3, 6, Laboratory showed improvement biomarkers except circulating eosinophils.Table IBaseline hospitalCharacteristicMean ± standard no. (%)(normal range)Age, y37.7 11.6SexMen, 51; women, 10Height, cm166.9 7.4Weight, kg63.3 11.1BMI22.7 20.9Disease duration, y29.5 14.3IGA3.6 0.5EASI score32.7 11.5EASI head face3.5 1.9Affected BSA, %65.7 20.9DLQI score11.6 5.9POEM score18.4 6.8VAS pruritus60.4 25.1Serum TARC level (pg/mL)3783.1 4811.7 (<450)Serum IgE (IU/mL)14,305 20,530.2 (<100)Serum LDH (U/L)269.8 89.6 (124–222)No. WBCs (/?L)6675.4 1830 (3300–8600)No. eosinophils (/?L)527.1 376 (66–344)No. neutrophils (/?L)4325.2 1662.7 (1683–5762)Platelet count (×103/?L)278.2 64.8 (158–348)Presence history asthma30/61 (including having childhood asthma)BMI, Body mass index; body surface area; DLQI, Dermatology Quality Life Index; EASI, IGA, Investigator's Global Assessment; IgE, immunoglobulin E; LDH, lactate dehydrogenase; POEM, Patient-Oriented Measure; TARC, thymus activation-regulated chemokine; VAS, visual analog scale; WBC, white blood cells. Open table new tab BMI, As adverse effects, conjunctivitis observed 13 (21.3%), 5 whom had allergic conjunctivitis. Conjunctivitis associated higher serum levels E chemokine severity.4Uchida Nagata al.Conjunctivitis setting.J 1247-1249Abstract (14) No discontinued because dupilumab-associated some manifestation face despite considerable trunk extremities. other concerns detected. Our study revealed that an setting, effects term. conducted North (50.5%), (36.8%), Asia-Pacific (12.7%) countries reported change parent ?89.0% ?90.0% weeks 52 76, respectively,1Deleuran whereas it –76.5% This suggests possibility slightly poorer response setting rather trials, ones.