Effectiveness and safety of dupilumab for the treatment of atopic dermatitis in a real-life French multicenter adult cohort - 21/06/19

Doi : 10.1016/j.jaad.2019.02.053

Sarah Faiz, MD ^a, Jonathan Giovannelli, MD, PhD ^a,^b, Céline Podevin, MSc ^b, Marie Jachiet, MD ^c, Jean-David Bouaziz, MD, PhD ^c, Ziad Reguiai, MD ^d, Audrey Nosbaum, MD, PhD ^e, Audrey Lasek, MD ^f, Marie-Christine Ferrier le Bouedec, MD ^g, Aurélie Du Thanh, MD, PhD ^h, Nadia Raison-Peyron, MD ^h, Florence Tetart, MD ⁱ, Anne-Bénédicte Duval-Modeste, MD ⁱ, Laurent Misery, MD, PhD ^j, François Aubin, MD, PhD ^k, Anne Dompmartin, MD, PhD ^l, Cécile Morice, MD ^l, Catherine Droitcourt, MD, PhD ^m, Angèle Soria, MD, PhD ⁿ, Jean-Philippe Arnault, MD, PhD ^o, Juliette Delaunay, MD ^p, Emmanuel Mahé, MD, PhD ^q, Marie-Aleth Richard, MD, PhD ^r, Amélie Schoeffler, MD ^s, Jean-Philippe Lacour, MD, PhD ^t, Edouard Begon, MD ^u, Amélie Walter-Lepage, MD ^v, Anne-Sophie Dillies, MD ^w, Sandrine Rappelle-Duruy, MD ^x, Stéphane Barete, MD, PhD ^y, Nathalia Bellon, MD ^z, Nathalie Bénéton, MD ^aa, Aude Valois, MD ^bb, Sébastien Barbarot, MD, PhD ^cc, Julien Sénéchal, MD, PhD ^dd,^ee, Delphine Staumont-Sallé, MD, PhD ^a,^b,^⁎
on behalf of the
Groupe de Recherche sur l'Eczéma aTopique (GREAT), France
^a CHU de Lille, Service de dermatologie, F-59000 Lille, France
^b Univ Lille, INSERM U995, Lille Inflammation Research International Center, F-59000, Lille, France
^c Dermatology Department, and Université́ Paris Diderot Paris VII, Sorbonne Paris Cité APHP, Saint Louis Hospital, Paris, France
^d Service de dermatologie, Polyclinique Courlancy, Reims, France
^e Allergy and Clinical Immunology Department, Lyon Sud University Hospital, Pierre Benite, University of Lyon, Lyon, France, CIRI (International Center for Infectiology Research), INSERM U1111, Ecole Normale Supérieure de Lyon, Université Claude Bernard Lyon 1, Lyon, France
^f Service de dermatologie, Hospital St Vincent de Paul, Groupement des Hôpitaux de l'Institut Catholique de Lille, France
^g Dermatology Department, University of Clermont-Ferrand, Clermont-Ferrand, France
^h Service de dermatologie, CHU Montpellier, Univ Montpellier, Montpellier, PCCI, INSERM, Univ Montpellier, Montpellier, France
ⁱ Department of Dermatology, Inserm U519, Rouen University Hospital, Rouen, France
^j Department of Dermatology, University Hospital of Brest, Brest, France
^k Service de dermatologie, Centre Hospitalier Régional Universitaire de Besançon Université de Franche Comté, Besançon, France
^l Department of Dermatology, Caen University Hospital Center, France
^m Service de Dermatologie, Centre Hospitalier Universitaire Pontchaillou, Université de Rennes, Rennes, France
ⁿ Service de Dermatologie et d'Allergologie, Hôpital Tenon, Paris HUEP, APHP, Paris, France Sorbonne Universités Paris, Centre d'Immunologie et des Maladies Infectieuses - Paris (Cimi-Paris), INSERM U1135, Paris, France
^o Department of Dermatology, Amiens University Hospital, Amiens, France
^p Service de Dermatologie, CHU d'Angers site Larrey, Angers, France
^q Department of Dermatology, Hôpital Victor Dupouy Argenteuil, Argenteuil, France
^r Aix-Marseille University, EA 3279, CEReSS- Health Service Research and Quality of Life Center, Dermatology Department, Timone Hospital, Assistance Publique Hôpitaux de Marseille, 13385, France
^s Service de Dermatologie, Hôpital Bel Air, Centre Hospitalier Régional Metz-Thionville
^t Service de Dermatologie, Hôpital l'Archet 2, CHU de Nice, France
^u Service de Dermatologie, Centre Hospitalier René-Dubos, Pontoise, France
^v Service de Dermatologie, CHU La Miletrie, Poitiers, France
^w Service de Dermatologie, Centre Hospitalier de Saint Quentin, France
^x Service de Dermatologie, Hôpital Joseph Imbert, Centre Hospitalier d'Arles, France
^y Unité Fonctionnelle de Dermatologie, Sorbonne Université, AP-HP, Hôpital La Pitié-Salpêtrière, Paris, France
^z Service de Dermatologie, Hôpital Necker, AP-HP, Paris, France
^aa Service de Dermatologie, Centre Hospitalier de Le Mans, France
^bb Service de Dermatologie, Hôpital d'Instruction des Armées Sainte Anne, Toulon, France
^cc Service de Dermatologie, Hôtel Dieu, CHU de Nantes, France
^dd Service de Dermatologie, Centre de Référence des Maladies Rares de la Peau, Hôpital Saint André, CHU de Bordeaux, France
^ee INSERM U1035 Biothérapie des Maladies Génétiques Inflammatoires et Cancers, Immuno-Dermatologie ATIP AVENIR, Université de Bordeaux, France

^∗Reprint requests: Delphine Staumont-Sallé, MD, PhD, Service de Dermatologie et Vénérologie, Hôpital Claude Huriez, CHRU de Lille, Rue Michel Polonowski, 59000 Lille, France.Service de Dermatologie et VénérologieHôpital Claude HuriezCHRU de LilleRue Michel PolonowskiLille59000France

Abstract

Background

Dupilumab is the first biologic available to treat atopic dermatitis (AD). Its effectiveness and safety were demonstrated in clinical trials.

Objective

We sought to assess the effectiveness and safety of dupilumab in adults with AD in a real-life French multicenter retrospective cohort.

Methods

We included patients treated during March 2017-April 2018. Efficacy outcomes, including Scoring Atopic Dermatitis (SCORAD) and Eczema Area and Severity Index (EASI) scores, were collected at baseline and 3 months when available. Adverse events (AEs) were recorded at follow-up.

Results

We included 241 patients. The median ± interquartile range (IQR) follow-up time was 3.8 ± 3.7 months. A ≥75% improvement in SCORAD was achieved in 27 of 163 (16.6%) patients, and a ≥75% improvement in EASI was achieved in 40 of 82 (48.8%) patients. The median SCORAD and EASI scores at 3 months were significantly lower than those at baseline (SCORAD ± IQR, 25 ± 21 vs 56 ± 27.4, P < 10⁻⁹ and EASI ± IQR, 4.1 ± 6.8 vs 17.9 ± 15.4, P < 10⁻⁹, respectively). Conjunctivitis was reported in 84 of 241 (38.2%) patients. The proportion with eosinophilia (>500 cells/mm³) during follow-up (57%) was higher than that at baseline (33.7%) (n = 172, P < 10⁻⁶). Dupilumab was stopped in 42 cases; 27 patients stopped because of AEs.

Limitations

No control group, missing data.

Conclusion

This real-life study demonstrated a similar dupilumab effectiveness as that seen in clinical trials, but it also revealed a higher frequency of conjunctivitis and eosinophilia.

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Key words : adults, atopic dermatitis, biotherapy, conjunctivitis, dupilumab, eosinophilia

Abbreviations used : AD, AE, DLQI, EASI, EASI50, EASI75, IQR, SCORAD, SCORAD50, SCORAD75

Plan

Methods

Study design and population

Baseline characteristics

Dupilumab effectiveness

AD flares

Dupilumab safety

Discontinuation of dupilumab

Discussion

	For the French Group of Research and Study in Atopic Dermatitis, the French Society of Dermatology.
	Funding sources: None.
	Conflicts of interest: Dr Jachiet, Prof Bouaziz, Dr Lasek, Dr Du-Thanh, Dr Raison-Peyron, Dr Tetart, Dr Duval-Modeste, Prof Misery, Prof Richard, Dr Barete, and Prof Seneschal received personal fees from Sanofi Genzyme. Dr Reguiai received personal fees from Leo-Pharma, AbbVie Inc, and Sanofi Genzyme. Dr Nosbaum received research grants and personal fees from Sanofi Genzyme. Dr Morice received personal fees from Sanofi Genzyme, Novartis, and Janssen. Dr Soria received personal fees from Sanofi Genzyme and Novartis. Prof Lacour received personal fees from Sanofi Genzyme and personal fees and research grants from Regenron, United States. Prof Barbarot received personal fees from Sanofi Genzyme, Leo Pharma, Janssen, AbbVie, Bioderma, and Pierre Fabres. Prof Staumont-Sallé received personal fees from Sanofi Genzyme. Dr Faiz, Dr Giovannelli, Ms Podevin, Dr Ferrier le Bouëdec, Prof Aubin, Prof Dompmartin, Dr Droitcourt, Dr Arnault, Dr Delaunay, Dr Mahé, Dr Schoeffler, Dr Begon, Dr Walter-Lepage, Dr Dillies, Dr Rappelle-Duruy, Dr Bellon, Dr Beneton, and Dr Valois have no conflicts of interest to disclose.

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Vol 81 - N° 1

P. 143-151 - juillet 2019 Retour au numéro

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Effectiveness and safety of dupilumab for the treatment of atopic dermatitis in a real-life French multicenter adult cohort - 21/06/19

Abstract

Background

Objective

Methods

Results

Limitations

Conclusion

Plan

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