Five-year real-world drug survival of dupilumab in severe atopic dermatitis and associate predictors
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. T...
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Taylor & Francis Group
2024-12-01
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| Series: | Journal of Dermatological Treatment |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/09546634.2024.2404718 |
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| author | Francesca Barei Paolo Calzari Luca Valtellini Alessandra Chiei Gallo Gabriele Perego Simona Tavecchio Martina Zussino Angelo V. Marzano Silvia Ferrucci |
| author_facet | Francesca Barei Paolo Calzari Luca Valtellini Alessandra Chiei Gallo Gabriele Perego Simona Tavecchio Martina Zussino Angelo V. Marzano Silvia Ferrucci |
| author_sort | Francesca Barei |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-c3cedb4b4eb94bc39837702e58b0f53f |
| institution | DOAJ |
| issn | 0954-6634 1471-1753 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Dermatological Treatment |
| spelling | doaj-art-c3cedb4b4eb94bc39837702e58b0f53f2025-08-20T02:49:32ZengTaylor & Francis GroupJournal of Dermatological Treatment0954-66341471-17532024-12-0135110.1080/09546634.2024.2404718Five-year real-world drug survival of dupilumab in severe atopic dermatitis and associate predictorsFrancesca Barei0Paolo Calzari1Luca Valtellini2Alessandra Chiei Gallo3Gabriele Perego4Simona Tavecchio5Martina Zussino6Angelo V. Marzano7Silvia Ferrucci8Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, ItalyDepartment of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, ItalyDermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, ItalyDepartment of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, ItalyDermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, ItalyDepartment of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, ItalyDermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, ItalyDermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, ItalyDermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, ItalyBackground 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.https://www.tandfonline.com/doi/10.1080/09546634.2024.2404718Atopic dermatitisdupilumabdrug-survivalassociate predictorspsoriasiform dermatitispsoriasis |
| spellingShingle | Francesca Barei Paolo Calzari Luca Valtellini Alessandra Chiei Gallo Gabriele Perego Simona Tavecchio Martina Zussino Angelo V. Marzano Silvia Ferrucci Five-year real-world drug survival of dupilumab in severe atopic dermatitis and associate predictors Journal of Dermatological Treatment Atopic dermatitis dupilumab drug-survival associate predictors psoriasiform dermatitis psoriasis |
| title | Five-year real-world drug survival of dupilumab in severe atopic dermatitis and associate predictors |
| title_full | Five-year real-world drug survival of dupilumab in severe atopic dermatitis and associate predictors |
| title_fullStr | Five-year real-world drug survival of dupilumab in severe atopic dermatitis and associate predictors |
| title_full_unstemmed | Five-year real-world drug survival of dupilumab in severe atopic dermatitis and associate predictors |
| title_short | Five-year real-world drug survival of dupilumab in severe atopic dermatitis and associate predictors |
| title_sort | five year real world drug survival of dupilumab in severe atopic dermatitis and associate predictors |
| topic | Atopic dermatitis dupilumab drug-survival associate predictors psoriasiform dermatitis psoriasis |
| url | https://www.tandfonline.com/doi/10.1080/09546634.2024.2404718 |
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