Dupilumab Quickly Improves Itching Symptoms in Atopic Dermatitis

By Jeff Craven /alert Contributor
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Adolescents and adults with atopic dermatitis (AD) saw improvement in itching symptoms as early as two days after starting on dupilumab, according to recent research released as an abstract for the American Academy of Allergy, Asthma & Immunology (AAAAI) 2020 Annual Meeting.

“Dupilumab treatment demonstrated rapid improvement in itch in adult and adolescent patients with moderate-to-severe AD,” Gil Yosipovitch, MD, of the University of Miami in Miami, Florida, said in an interview with M.D. /alert. “Dupilumab was also generally well-tolerated with an acceptable safety profile.”

Yosipovitch and colleagues performed a post-hoc analysis of pruritis symptoms in patients with AD from the phase 3 SOLO 1 & SOLO 2, AD ADOL, and CHRONOS studies. The results were also published in an article in press in the Journal of the American Academy of Dermatology

In the SOLO 1 and 2 trials, patients were divided into groups who received 300 mg of dupilumab per week, 300 mg every 2 weeks, or a placebo. Patients in the ADOL trial consisted of adolescents who received 200 mg or 300 mg of dupilumab every 2 weeks, 300 mg every 4 weeks, or a placebo. Investigators noted patients from the four trials had similar baseline characteristics, with higher AD severity among adolescents. 

The primary outcome was a change in Peak Pruritus Numerical Rating Scale (NRS) at 15 days from baseline. At baseline, NRS scores for adults were 7.3 in the dupilumab weekly group, 7.4 in the group receiving dupilumab every two weeks, and 7.4 in the placebo group. Among adolescents, baseline NRS scores were 7.5 points in the group receiving dupilumab weekly every 2 weeks, and 7.7 points in the placebo group.

Two days after administration, adult patients in the dupilumab group had significantly improved pruritis compared with the placebo group (P ≤ .003) and this effect occurred by 6 days after administration for adolescents (P < .01). Adult patients at 15 days had a least square (LS) mean percent change of 222.5 in the weekly dupilumab group (P < .0001), 224.7 LS mean percent change in the group receiving dupilumab every 2 weeks (P < .0001), and 23.4 LS mean percent change in the placebo group. In adolescents, there was a LS mean percent change of 225.3 in the group receiving dupilumab every 2 weeks (P < .0001), LS mean percent change of 221.8 in the group receiving the drug every 4 weeks (P < .0001), and 25.7 LS mean percent change in the placebo group.

“Atopic dermatitis is characterized by intense itch that is one of the most burdensome symptoms; therefore, rapid and sustained improvement in itch is an important marker of treatment benefit. The rapid response on itch precedes the effect on the atopic rash in both adults and adolescent, as itch is a key driver of the disease,” Yosipovitch said. “It’s important to address this question and document it during an intake.”


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