Journal of Asthma and Allergy (Nov 2023)
Dupilumab Treatment Efficacy and Impact on Clinical Scores, Serum Biomarkers, and Itch in Adult Patients with Atopic Dermatitis: A Retrospective Analysis
Abstract
Mariateresa Rossi,* Luca Bettolini,* Grazia Linda Artelli, Alessandro Fraghì, Cesare Tomasi, Piergiacomo Calzavara-Pinton Dermatology Department, University of Brescia, ASST Spedali Civili di Brescia, Brescia, Italy*These authors contributed equally to this workCorrespondence: Luca Bettolini, Department of Dermatology, Spedali Civili, University of Brescia, Brescia, Italy, Tel +39 030 3995301, Fax +39 030 399505, Email [email protected]: Dupilumab, a fully human monoclonal antibody that inhibits the signaling pathways of interleukin (IL)-4 and IL-13, has demonstrated remarkable efficacy in the treatment of atopic dermatitis (AD). Dupilumab has been reported to attenuate itch and reduce several serum markers, including blood lactate dehydrogenase (LDH), blood eosinophil count, and serum total immunoglobulin E (IgE).Patients and Methods: The present study investigated retrospectively changes in clinical scores and serum biomarker from 175 adults with moderate-to-severe AD treated with dupilumab. Clinical manifestations were assessed using eczema area and severity index (EASI) and visual analogue scale (VAS) for itch at baseline and subsequently at 16-week intervals up to a duration of 48 weeks. Total IgE, LDH and blood eosinophil count were also collected.Results: The dupilumab treatment significantly improved EASI and VAS scores and decreased serum levels of IgE, LDH, and total eosinophil count. The EASI scores were positively correlated with VAS for itch at all recorded time points, whereas serum biomarkers did not exhibit a strong correlation with EASI scores.Conclusion: These findings highlight the close relationship between the extent and severity of eczema and the intensity of itch experienced by patients and suggest that factors beyond the measured serum biomarkers play a significant role in the clinical manifestations of AD, emphasizing the complex nature of the disease.Keywords: atopic dermatitis, dupilumab, itch, immunoglobulin E, eosinophils, lactate dehydrogenase
