Article Dans Une Revue World Allergy Organization Journal Année : 2024

Real-life management of atopic dermatitis patients with an inadequate response to on-label use of dupilumab

Résumé

In patients with moderate to severe atopic dermatitis (AD) showing an inadequate response to dupilumab 300mg/2weeks, few real-life studies reported the response to alternative regimen maintaining dupilumab. To assess and analyze the response to an increased dose of dupilumab or its combination with cyclosporin A (CsA), methotrexate (MTX), or itraconazole (ITRA), all adult AD patients from 7 French University Hospitals were retrospectively included if they achieved an inadequate response to dupilumab 300mg/2weeks and were subsequently treated with an increased dose of dupilumab (300mg every 7 or 10 days), or a combination of dupilumab 300mg/2weeks with CsA, MTX or ITRA. The response after 3 months, along with epidemiological, clinical, and therapeutic baseline characteristics, were collected. Overall, 68.75% of the 48 included patients achieved an improved response, including 45.8% of complete response (CR). No strategy proved significantly better. Patients showing an initial no response never achieved a further CR versus 52.4% of patients with an initial partial response (p = 0.025). Digestive intolerance and tachycardia led to MTX and ITRA discontinuation in 3 patients. Increasing the dose of dupilumab or combining it with CsA, MTX, or ITRA could be alternative and safe options, to be evaluated in further medico-economic studies.
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hal-04816567 , version 1 (03-12-2024)

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Rémi Strizzolo, Julien Seneschal, Angèle Soria, Delphine Staumont-Sallé, Sébastien Barbarot, et al.. Real-life management of atopic dermatitis patients with an inadequate response to on-label use of dupilumab. World Allergy Organization Journal, 2024, 17 (7), pp.100923. ⟨10.1016/j.waojou.2024.100923⟩. ⟨hal-04816567⟩
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