Attenuating the atopic march: Meta-analysis of the dupilumab atopic dermatitis database for incident allergic events - 03/03/23
, Dateng Li, PhD, Meng Xu, PhD, Kusha Mohammadi, PhD, Richa Attre, PhD, Marius Ardeleanu, MD, Bret Musser, PhDGraphical abstract |
Abstract |
Background |
Atopic march refers to the sequential development of allergic diseases from infancy through adolescence, typically beginning with atopic dermatitis (AD), followed by food allergy and then airway diseases, later evolving to broader or worsened spectrum of allergic diatheses. No intervention has shown to alter its course.
Objective |
We sought to determine the rate of acquisition of new or worsened allergic events for dupilumab versus placebo in patients with AD.
Methods |
Allergy-associated events from 12 clinical trials were grouped into 17 allergy categories, and IgE changes from baseline were defined. A new/worsened event was considered one step of atopic march. Treatment effect was assessed by incidence rate ratios (IRRs), dupilumab versus placebo, by meta-analysis.
Results |
The duration of pooled AD studies was 4 to 52 weeks (1359 patient-years; n = 2296 dupilumab, n = 1229 placebo, median age 35 years). The median age at AD onset was 2 years. Baseline allergic disease burden was comparable between groups. Dupilumab reduced the risk of new/worsening allergies by 34% (IRR 0.66; 95% confidence interval [CI], 0.52-0.84) and new allergies by 37% (IRR 0.63; 95% CI, 0.48-0.83) versus placebo. Including IgE category shift, the IRR for combined new/worsening allergies was reduced by 54% (IRR 0.46; 95% CI, 0.36-0.57). These treatment benefits did not reverse on treatment discontinuation in off-treatment follow-up.
Conclusions |
The acquisition/worsening of allergic conditions suggestive of atopic march was observed in a pooled adult/adolescent AD study population with inadequately controlled AD. Treatment with dupilumab reduced new/worsened allergy events versus placebo; inclusion of IgE category change increased the apparent benefit.
Le texte complet de cet article est disponible en PDF.Key words : Atopic march, dupilumab, dermatitis, atopic, food hypersensitivity, eczema, antibodies, monoclonal, asthma, rhinitis, allergic, IgE responsiveness, atopic, meta-analysis
Abbreviations used : AD, CI, EASI, IRR, TEAE
Plan
| This analysis was funded by Regeneron Pharmaceuticals, Inc, Tarrytown, NY, according to Good Publication Practice guidelines. The authors were involved in the study design and collection, analysis, and interpretation of data. All authors had full access to all the data in this study and take complete responsibility for the integrity of the data and accuracy of the data analysis. |
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| Disclosure of potential conflict of interest: All authors are employees of and stakeholders in Regeneron Pharmaceuticals, Inc. |
Vol 151 - N° 3
P. 756-766 - mars 2023 Retour au numéro
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