Clinical course of atopic dermatitis after dupilumab discontinuation: a multicentre real-world study.
Обработка статьи · этапы, ошибки и управление
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.
Barei Francesca, Macchi Stefano, Calzari Paolo, Ribero Simone, Ortoncelli Michela, Foti Caterina, Balato Anna, Di Brizzi Eugenia Veronica, Peris Ketty, Gori Niccolò, Ippoliti Elena, Gurioli Carlotta, Piraccini Bianca Maria, Trave Ilaria, Cozzani Emanuele, Pezzolo Elena, Bonzano Laura, Errichetti Enzo, Schettini Natale, Nettis Eustachio, Gola Massimo, Milanesi Nicola, Feliciani Claudio, De Felici Del Giudice Maria Beatrice, Campanati Anna, Gioacchini Helena, Pisapia Armando, Avallone Gianluca, Micali Giuseppe, Musumeci Maria Letizia, Ortega Romina, Manzo Margiotta Flavia, Romanelli Marco, Hansel Katharina, Stingeni Luca, Patruno Cataldo, Esposito Maria, Fargnoli Maria Concetta, De Berardinis Andrea, Ferreli Caterina, Calabrese Laura, Rubegni Pietro, Lazzeri Laura, Grigolato Laura, Galli Benedetta, Rossi Mariateresa, Maurelli Martina, Girolomoni Giampiero, Lauletta Giuseppe, Napolitano Maddalena, Alfano Angela, Gargiulo Luigi, Narcisi Alessandra, Marzano Angelo Valerio, Ferrucci Silvia Mariel
Аннотация
OBJECTIVES: To assess disease progression following dupilumab discontinuation.
METHODS: A multicentre, retrospective study was conducted on 208 patients with severe AD who discontinued dupilumab for reasons unrelated to inefficacy. The Eczema Area and Severity Index (EASI), pruritus numerical rating scale (P-NRS), Atopic Dermatitis Control Tool (ADCT) and Dermatology Life Quality Index (DLQI) were used to assess disease activity after discontinuation. Kaplan-Meier analysis was used to estimate the time and probability of disease worsening (defined as EASI > 7.0, EASI increase ≥ 6.6, P-NRS ≥ 4, P-NRS increase ≥ 4, ADCT ≥ 7, ADCT increase ≥ 5, or DLQI increase ≥ 4), as well as the need to restart systemic treatment.
RESULTS: The main reasons for discontinuing dupilumab were clinical remission or good clinical control (43.3%), patient's decision (11.1%) and pregnancy or desire to become pregnant (20.7%). Patients with a family history of AD or nonclassical phenotypes had a significantly higher likelihood of disease worsening. A significant portion (42.8%) of patients resumed systemic treatment within a median time of 47 weeks. They had a baseline median EASI score of 10.0 and a median P-NRS of 6.0. The probability of resuming systemic treatment was 25% at 31 weeks and 50% at 94 weeks. Reinitiation of dupilumab significantly improved EASI and P-NRS scores within 16 weeks.
CONCLUSIONS: Discontinuing dupilumab is associated with disease recurrence in some patients, especially those with a family history or nonclassical AD. Dupilumab reinitiation is effective, leading to significant clinical improvements and supporting its use after treatment interruption.