In patients with moderate-to-severe atopic dermatitis (AD), dupilumab significantly reduces hospitalization rates and hospitalization length related to AD.
Atopic dermatitis (AD), a chronic inflammatory skin disease, may necessitate inpatient hospitalization for refractory cases, severe flares (exacerbations), and infections. A U.S. study also found that 18.9% of hospitalized individuals with a primary diagnosis of AD or eczema arrived with a skin infection, compared to 4.3% of hospitalized adults without a primary diagnosis of AD or eczema. Significantly elevated hospitalization rates and expenses have been linked with cutaneous infections in AD patients compared to those without skin infections.
This case-control study was published in The Journal of Allergy and Clinical Immunology: In Practice and compared the hospitalization rates between dupilumab-treated and placebo-treated patients with moderate-to-severe AD.
Data from 7 placebo-controlled, phase 2 or 3, randomized controlled trials, including 2,932 patients with moderate-to-severe AD were included. Patients were administered 300 mg of dupilumab every two weeks (q2w) or weekly (qw) against a placebo for 12, 16, or 52 weeks.
Ultimately, it was observed that patients in the dupilumab 300 mg q2w, qw, and combined dupilumab (q2w and qw;) groups had lower rates of all-cause hospitalizations (5.8, 2.7, and 3.8 events, respectively, vs. 9.0 events per 100 patient-years (PY).
In addition, dupilumab-treated individuals demonstrated a trend toward fewer AD-related inpatient days than control patients. Furthermore, the chance of hospitalization was decreased in patients treated with dupilumab compared to patients in the control group.
Even though all-cause hospitalizations may include occurrences unrelated to the medicine or AD, a reduction in all-cause hospitalizations gives additional information pertinent to the safety profile of dupilumab.
For those treated with dupilmab (300mg q2w) , there was a 49% reduction in all-cause hospitalizations and a 60% reduction in AD-related hospitalizations. Furthermore, hospitalization length was reduced from 38.9 days per 100 PY for the control group to 10.9 days per 100 PY for the dupilumab group.
The authors concluded that the treatment with dupilumab was associated with significant decreases in all-cause and AD-related hospitalization rates and shorter duration of AD-related hospitalization among individuals with moderate-to-severe AD.
Dupilumab likely lowers infectious episodes through local action involving the reduction of inflammation and enhancement of the skin barrier and systemic action involving the downregulation of T-helper type 2-driven inflammation.
Reference:
Silverberg, J. I., Rubini, N. P. M., Pires, M. C., Rossi, A. B., Zhang, A., Chen, Z., . . . Bégo-Le Bagousse, G. (2022). Dupilumab Treatment Reduces Hospitalizations in Adults With Moderate-to-Severe Atopic Dermatitis. J Allergy Clin Immunol Pract, 10(5), 1279-1285.e1271. doi:10.1016/j.jaip.2021.11.034
