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Real-world experience from the UK

Study of patients with severe recalcitrant AD over a period of 1 year after beginning treatment with DUPIXENT2


LONDON ROYAL FREE HOSPITAL: 65 patients, reviews at 4, 12, 24, 52 weeks following DUPIXENT2

Mean EASI score and proportion of patients achieving EASI-75 and EASI-90*2

At 52 weeks the mean EASI score was 2.3 compared to 25.5 at baseline2


At 52 weeks 68% of patients achieved ≥90% improvement in lesion extent and severity (EASI-90)2

Mean SCORAD score at baseline and review checkpoints†2

At 52 weeks the mean SCORAD score was 13.9 compared to 54.7 at baseline2

A one-year review of 65 patients with severe recalcitrant atopic dermatitis. Outcomes were recorded between at 4, 12, 16 24, and 52 weeks. Patients received DUPIXENT fortnightly.2 Study patients who had failed to respond to or were intolerant of an average of 3.45 previous immunosuppressants. These were principally methotrexate (n=60), ciclosporin (n=59), azathioprine (n=44) and mycophenolate mofetil (n=41).2

Mean DLQI score at baseline and review checkpoints‡2

At 52 weeks the mean DLQI score was 4.2 compared to 14.8 at baseline2

Mean POEM score at baseline and review checkpoints§2

At 52 weeks the mean POEM score was 5.4 compared to 20.5 at baseline2

A one-year review of 65 patients with severe recalcitrant atopic dermatitis. Outcomes were recorded between at 4, 12, 16 24, and 52 weeks. Patients received DUPIXENT fortnightly.2 Study patients who had failed to respond to or were intolerant of an average of 3.45 previous immunosuppressants. These were principally methotrexate (n=60), ciclosporin (n=59), azathioprine (n=44) and mycophenolate mofetil (n=41).2

Baseline characteristics

LONDON ROYAL FREE HOSPITAL
(N=65)
Mean age (years) 42
Mean EASI 25.5

DUPIXENT safety profile in the London royal free hospital study2

n (%)
Total 4 (6%)
Suicidal ideation 2 (3%)
Low efficacy 1 (2%)
Alopecia areata 1 (2%)

*An EASI score is based on a clinician’s weighted score (0 to 72) of four affected areas grading the physical signs of AD (erythema, oedema/papulation, excoriation, lichenification).3–7

A SCORAD score combines of the extent of AD across six affected areas (Head/neck, upper limbs, lower limbs, anterior trunk, back, genitals) and the intensity of the physical signs of AD (redness, swelling, oozing/crusting, scratch marks, skin thickening, dryness). The maximum score is 103 with higher scores indicating more severe AD.8

The DLQI score is based on a 10-item patient questionnaire that assesses six different aspects that may affect quality of life. These aspects are symptoms and feelings, daily activities, leisure, work and school performance, personal relationships, and treatment. Each question is scored from 0 (not at all) to 3 (very much) and then totalled for the final score.3,4

§The POEM score is based on scores from seven items each assessed on a five-point scale. The maximum score is 28 and higher scores indicate a poorer quality of life.4

Hypereosinophilia was the most frequent blood abnormality.


AD, atopic dermatitis; DLQI, Dermatology Life Quality Index; EASI, Eczema Area and Severity Index; POEM, patient-oriented eczema measure; SCORAD, SCORing Atopic Dermatitis SE, standard error; UK, United Kingdom.


References

  1. DUPIXENT Summary of Product Characteristics. September 2021.
  2. Gardette E, et al. Real-world experience of dupilumab for the treatment of severe recalcitrant atopic dermatitis in a tertiary centre. Abstract O06. Presented at the 99th British Association of Dermatologists Annual meeting, Liverpool, July 2–4 2019.
  3. © NICE [2018] Dupilumab for treating moderate to severe atopic dermatitis. Available at: https://www.nice.org.uk/guidance/TA534/chapter/1-Recommendations. Date accessed: December 2021. All rights reserved. Subject to notice of rights. NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this product/publication.
  4. Clinical Review Report: Dupilumab (Dupixent): (Sanofi-Aventis Canada Inc.): Indication: Moderate-to-severe atopic dermatitis (AD) [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2018 Jul. Appendix 5, Validity of Outcomes Measures. Available at: https://www.ncbi.nlm.nih.gov/books/NBK539234/. Date accessed: December 2021.
  5. EASI User Guide. HOME – Harmonising Outcome Measures for Eczema website. Available at: http://www.homeforeczema.org/documents/easi-user-guide-dec-2016-v2.pdf. Date accessed: December 2021.
  6. Leshem YA, et al. Br J Dermatol. 2015;172(5):1353–1357.
  7. Fattah D, et al. Chair’s presentation. Dupilumab for treating moderate to severe atopic dermatitis (ID1048) presented at the 2nd Appraisal Committee meeting lead team presentation, May 10 2018.
  8. Stalder J F, et al. Scoring of Atopic Dermatitis: The SCORAD Index. Dermatology 1993;186:23-31. doi: 10.1159/000247298.