Treating erythrodermic atopic dermatitis with the monoclonal antibody dupilumab
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Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by An Duc Thien Le |
Posted on May 8th, 2023
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Erythrodermic atopic dermatitis (AD) is a more severe subtype in which more than 90% of the body surface area of the patient is marked with erythema and pruritus. Topical corticosteroids are commonly used as a treatment but application to the entire body is not practical. Dupilumab is a monoclonal antibody that can block the proinflammatory effect of the IL-4 and IL-13 cytokine, and a study examining its effect on erythrodermic atopic dermatitis had recently been published in the Journal of the American Medical Association.
The paper included data extracted from 6 different randomized, placebo-controlled trials. There were a total of 3075 participants with moderate to severe atopic dermatitis, 209 of whom were diagnosed with erythrodermic atopic dermatitis. These patients were treated with dupilumab monotherapy or combination with topical corticosteroids; the results were compared with another group that received placebo. The researchers found that, in patients affected with erythrodermic atopic dermatitis, the usage of dupilumab monotherapy once a week helped reduce the body surface area being affected by atopic dermatitis by 42%, which was significantly higher than the 17% reduction in the placebo group. The study did not find any increase in benefit when dupilumab is administered twice per week. Also, when dupilumab is combined with topical corticosteroids treatment, the body surface area being affected by atopic dermatitis significantly reduced by 63%. This degree of clinical improvement was reflected when severity was compared using other parameters such as the Eczema Area and Severity Index (EASI) and the Peak Pruritus NumericalRating Scale (PP-NRS). When compared to placebo, the treatment is relatively safe; the most common adverse effects associated with dupilumab were injection-site reaction, conjunctivitis, and nasopharyngitis.
The paper included data extracted from 6 different randomized, placebo-controlled trials. There were a total of 3075 participants with moderate to severe atopic dermatitis, 209 of whom were diagnosed with erythrodermic atopic dermatitis. These patients were treated with dupilumab monotherapy or combination with topical corticosteroids; the results were compared with another group that received placebo. The researchers found that, in patients affected with erythrodermic atopic dermatitis, the usage of dupilumab monotherapy once a week helped reduce the body surface area being affected by atopic dermatitis by 42%, which was significantly higher than the 17% reduction in the placebo group. The study did not find any increase in benefit when dupilumab is administered twice per week. Also, when dupilumab is combined with topical corticosteroids treatment, the body surface area being affected by atopic dermatitis significantly reduced by 63%. This degree of clinical improvement was reflected when severity was compared using other parameters such as the Eczema Area and Severity Index (EASI) and the Peak Pruritus NumericalRating Scale (PP-NRS). When compared to placebo, the treatment is relatively safe; the most common adverse effects associated with dupilumab were injection-site reaction, conjunctivitis, and nasopharyngitis.