In:
Frontiers in Immunology, Frontiers Media SA, Vol. 14 ( 2023-4-20)
Abstract:
The real-world experience of dupilumab in Chinese is limited, and the initial loading dose has not yet been deeply explored in patients aged & lt;6 years. Objective To explore the efficacy and safety of dupilumab in Chinese patients with moderate-to-severe atopic dermatitis and investigate the effect of higher loading dose for disease control in patients aged & lt;6 years. Methods A total of 155 patients were divided into three groups according to age: & lt;6 years, 6-11 years, and & gt;11 years. Among patients aged & lt;6 years, 37 patients received a high loading dose of 300 mg for body weight & lt;15kg or 600 mg for body weight ≥15kg, and another 37 patients received a standard loading dose of 200 mg for body weight & lt;15kg or 300 mg for body weight ≥15kg. Multiple physicians and patient-reported outcome measures were evaluated at baseline and 2, 4, 6, 8, 12, and 16 weeks after dupilumab treatment. Results The proportion of patients showing an improvement of ≥75% in the Eczema Area and Severity Index was 68.0% (17/25), 76.9% (10/13), and 62.5% (25/40) in the aged & lt;6, 6-11, and & gt;11 years groups, respectively, at week 16. After increasing the loading dose, 69.6% (16/23) of patients aged & lt;6 years achieved 4-point improvement in Pruritus Numerical Rating Scale at week 2, compared with 23.5% (8/34) of patients receiving standard loading dose ( P & lt; 0.001). Obesity (odds ratio=0.12, 95% confidence interval: 0.02-0.70) was predictive of a poor response to dupilumab treatment, while female (odds ratio=3.94, 95% confidence interval: 1.26-12.31) predicted good response at week 16. The change of serum C-C motif ligand 17(CCL17/TARC) could reflect the response to dupilumab ( r = 0.53, P = 0.002 in EASI) among patients aged & lt;18 years. No major adverse events were reported during the treatment. Conclusions Dupilumab was effective and well-tolerated in Chinese patients with atopic dermatitis. The increased loading dose helped achieve rapid pruritus control in patients aged & lt;6 years.
Type of Medium:
Online Resource
ISSN:
1664-3224
DOI:
10.3389/fimmu.2023.1160710
DOI:
10.3389/fimmu.2023.1160710.s001
Language:
Unknown
Publisher:
Frontiers Media SA
Publication Date:
2023
detail.hit.zdb_id:
2606827-8
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