Frontiers in medicine · 2026
Efficacy and safety of dupilumab in moderate-to-severe atopic dermatitis with stage 3-5 chronic kidney disease: a retrospective real-world study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wei Jiali, Huang Yiqi
Аннотация
AIMS: To evaluate dupilumab efficacy and safety in stage 3-5 chronic kidney disease (CKD) patients with moderate-to-severe atopic dermatitis (AD).
METHODS: This retrospective study included 29 such patients receiving dupilumab who completed 12 and 24 weeks of follow-up. Assessments included Eczema Area and Severity Index (EASI), Pruritus Numeric Rating Scale (NRS), Sleep NRS, Dermatology Life Quality Index (DLQI), and Clinical Frailty Scale (CFS), eosinophils, interleukin-10 (IL-10), regulatory T cell (Treg) proportions, and renal function [estimated glomerular filtration rate (eGFR), serum creatinine, and urine protein-to-creatinine ratio (UPCR)]. Adverse events were recorded.
RESULTS: At week 12, mean EASI score decreased from 34.94 ± 7.96 at baseline to 19.31 ± 6.09 (44.7% reduction), with 76.0% of patients achieving EASI-50. Pruritus NRS decreased from 7.72 ± 1.75 to 3.72 ± 1.75 (51.8% reduction), and 88.0% achieved a ≥ 4-point improvement. DLQI improved by 52.1%, and 100% of patients achieved a ≥ 4-point improvement. CFS score decreased by 17.5%. Eosinophil counts decreased by 25.0%, while IL-10 and Treg proportions increased by 49.9% and 50.8%, respectively. At week 24, EASI-50, EASI-75, and EASI-90 response rates were 100%, 76.9%, and 7.7%, respectively; 100% of patients achieved ≥4-point improvements in both pruritus NRS and DLQI. IL-10 and Treg continued to rise, and CFS score was significantly reduced from baseline (P = 0.001). Renal function parameters remained stable throughout the 24-week follow-up: mean eGFR showed a minimal decline from 37.93 ± 14.88 to 36.39 ± 14.77 mL/min/1.73 m2 at week 24 (P = 0.073), serum creatinine and UPCR also showed no significant changes (P = 0.130 and P = 0.069, respectively). Only two mild-to-moderate adverse events (injection-site reaction and conjunctivitis) occurred, both resolved with symptomatic management. No treatment discontinuation, death, or worsening of renal function was reported.
CONCLUSION: Dupilumab effectively improves skin lesions, pruritus, sleep, quality of life, and frailty, while showing changes consistent with regulatory immune modulation in patients with stage 3-5 CKD and moderate-to-severe AD, with a favorable safety profile. Renal impairment alone should not be considered an absolute contraindication, although patients with advanced CKD require careful monitoring.
METHODS: This retrospective study included 29 such patients receiving dupilumab who completed 12 and 24 weeks of follow-up. Assessments included Eczema Area and Severity Index (EASI), Pruritus Numeric Rating Scale (NRS), Sleep NRS, Dermatology Life Quality Index (DLQI), and Clinical Frailty Scale (CFS), eosinophils, interleukin-10 (IL-10), regulatory T cell (Treg) proportions, and renal function [estimated glomerular filtration rate (eGFR), serum creatinine, and urine protein-to-creatinine ratio (UPCR)]. Adverse events were recorded.
RESULTS: At week 12, mean EASI score decreased from 34.94 ± 7.96 at baseline to 19.31 ± 6.09 (44.7% reduction), with 76.0% of patients achieving EASI-50. Pruritus NRS decreased from 7.72 ± 1.75 to 3.72 ± 1.75 (51.8% reduction), and 88.0% achieved a ≥ 4-point improvement. DLQI improved by 52.1%, and 100% of patients achieved a ≥ 4-point improvement. CFS score decreased by 17.5%. Eosinophil counts decreased by 25.0%, while IL-10 and Treg proportions increased by 49.9% and 50.8%, respectively. At week 24, EASI-50, EASI-75, and EASI-90 response rates were 100%, 76.9%, and 7.7%, respectively; 100% of patients achieved ≥4-point improvements in both pruritus NRS and DLQI. IL-10 and Treg continued to rise, and CFS score was significantly reduced from baseline (P = 0.001). Renal function parameters remained stable throughout the 24-week follow-up: mean eGFR showed a minimal decline from 37.93 ± 14.88 to 36.39 ± 14.77 mL/min/1.73 m2 at week 24 (P = 0.073), serum creatinine and UPCR also showed no significant changes (P = 0.130 and P = 0.069, respectively). Only two mild-to-moderate adverse events (injection-site reaction and conjunctivitis) occurred, both resolved with symptomatic management. No treatment discontinuation, death, or worsening of renal function was reported.
CONCLUSION: Dupilumab effectively improves skin lesions, pruritus, sleep, quality of life, and frailty, while showing changes consistent with regulatory immune modulation in patients with stage 3-5 CKD and moderate-to-severe AD, with a favorable safety profile. Renal impairment alone should not be considered an absolute contraindication, although patients with advanced CKD require careful monitoring.