C Patruno1, M Napolitano2, G Argenziano3, K Peris4,5, M Ortoncelli6, G Girolomoni7, A Offidani8, S M Ferrucci9, G F Amoruso10, M Rossi11, L Stingeni12, G Malara13, T Grieco14, C Foti15, M Gattoni16, C Loi17, M Iannone18, M Talamonti19, G Stinco20, F Rongioletti21, P D Pigatto22, A Cristaudo23, E Nettis24, M Corazza25, F Guarneri26, P Amerio27, M Esposito28, A Belloni Fortina29, C Potenza30, G Fabbrocini31. 1. Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy. 2. Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy. 3. Dermatology Unit, University of Campania, Naples, Italy. 4. Dermatology, University of the Sacred Heart, Rome, Italy. 5. Fondazione Policlinico Universitario A.Gemelli, IRCCS, Rome, Italy. 6. Dermatology Clinic, University of Turin, Turin, Italy. 7. Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy. 8. Dermatology Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy. 9. Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy. 10. AO Cosenza, UOC Dermatologia, Cosenza, Italy. 11. UO Dermatologia, ASST Spedali Civili di Brescia, Brescia, Italy. 12. Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy. 13. Struttura Complessa di Dermatologia, Grande Ospedale Metropolitano 'Bianchi Melacrino Morelli', Reggio Calabria, Italy. 14. Dermatology Unit, Sapienza University of Rome, Rome, Italy. 15. Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy. 16. Dermatologic Department, S. Andrea Hospital Vercelli, Vercelli, Italy. 17. Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy. 18. Department of Dermatology, University of Pisa, Pisa, Italy. 19. Dermatology Unit, Policlinico Tor Vergata, Department of Systemic Medicine, Tor Vergata University of Rome, Rome, Italy. 20. Department of Medicine, Institute of Dermatology, University of Udine, Udine, Italy. 21. Unit of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy. 22. Department of Medical, Surgical and Odontoiatric Science, IRCCS Ospedale Ortopedico Galeazzi, Milano, Italy. 23. San Gallicano Dermatologic Institute IRCCS, Rome, Italy. 24. Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari - Aldo Moro, Bari, Italy. 25. Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy. 26. Department of Clinical and Experimental Medicine, Dermatology, University of Messina, Messina, Italy. 27. Dermatologic Clinic, SS. Annunziata Hospital, Chieti, Italy. 28. Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy. 29. Unit of Dermatology, Department of Medicine DIMED, University of Padua, Padua, Italy. 30. Dermatology Unit 'Daniele Innocenzi', Department of MEDICO-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy. 31. Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy.
Abstract
BACKGROUND: Treatment of moderate-to-severe atopic dermatitis (AD) in the elderly may be challenging, due to side-effects of traditional anti-inflammatory drugs and to comorbidities often found in this age group. Furthermore, efficacy and safety of innovative drugs such as dupilumab are not yet well known. OBJECTIVES: A multicentre retrospective, observational, real-life study on the efficacy and safety of dupilumab was conducted in a group of patients aged ≥65 years and affected by severe AD. Their main clinical features were also examined. METHODS: Data of elderly patients with severe (EASI ≥24) AD treated with dupilumab at label dosage for 16 weeks were retrospectively collected. Treatment outcome was assessed by comparing objective (EASI) and subjective (P-NRS, S-NRS and DLQI) scores at baseline and after 16 weeks of treatment. RESULTS: Two hundred and seventy-six patients were enrolled in the study. They represented 11.37% of all patients with severe AD. Flexural eczema was the most frequent clinical phenotype, followed by prurigo nodularis. The coexistence of more than one phenotype was found in 63/276 (22.82%) subjects. Data on the 16-week treatment with dupilumab were available for 253 (91.67%) patients. Efficacy of dupilumab was demonstrated by a significant reduction of all the scores. No statistically significant difference regarding efficacy was found in elderly patients when compared to the group of our AD patients aged 18-64 years, treated with dupilumab over the same period. Furthermore, only 18 (6.52%) patients discontinued the drug due to inefficacy. Sixty-one (22.51%) patients reported adverse events, conjunctivitis and flushing being the most frequent. One (0.36%) patient only discontinued dupilumab due to an adverse event. CONCLUSIONS: Therapy with dupilumab led to a significant improvement of AD over a 16-week treatment period, with a good safety profile. Therefore, dupilumab could be considered as an efficacious and safe treatment for AD also in the elderly.
BACKGROUND: Treatment of moderate-to-severe atopic dermatitis (AD) in the elderly may be challenging, due to side-effects of traditional anti-inflammatory drugs and to comorbidities often found in this age group. Furthermore, efficacy and safety of innovative drugs such as dupilumab are not yet well known. OBJECTIVES: A multicentre retrospective, observational, real-life study on the efficacy and safety of dupilumab was conducted in a group of patients aged ≥65 years and affected by severe AD. Their main clinical features were also examined. METHODS: Data of elderly patients with severe (EASI ≥24) AD treated with dupilumab at label dosage for 16 weeks were retrospectively collected. Treatment outcome was assessed by comparing objective (EASI) and subjective (P-NRS, S-NRS and DLQI) scores at baseline and after 16 weeks of treatment. RESULTS: Two hundred and seventy-six patients were enrolled in the study. They represented 11.37% of all patients with severe AD. Flexural eczema was the most frequent clinical phenotype, followed by prurigo nodularis. The coexistence of more than one phenotype was found in 63/276 (22.82%) subjects. Data on the 16-week treatment with dupilumab were available for 253 (91.67%) patients. Efficacy of dupilumab was demonstrated by a significant reduction of all the scores. No statistically significant difference regarding efficacy was found in elderly patients when compared to the group of our ADpatients aged 18-64 years, treated with dupilumab over the same period. Furthermore, only 18 (6.52%) patients discontinued the drug due to inefficacy. Sixty-one (22.51%) patients reported adverse events, conjunctivitis and flushing being the most frequent. One (0.36%) patient only discontinued dupilumab due to an adverse event. CONCLUSIONS: Therapy with dupilumab led to a significant improvement of AD over a 16-week treatment period, with a good safety profile. Therefore, dupilumab could be considered as an efficacious and safe treatment for AD also in the elderly.
Authors: Eustachio Nettis; Luisa Brussino; Vincenzo Patella; Laura Bonzano; Aikaterini Detoraki; Elisabetta Di Leo; Maria Maddalena Sirufo; Cristiano Caruso; Fabio Lodi Rizzini; Mariaelisabetta Conte; Mona-Rita Yacoub; Massimo Triggiani; Erminia Ridolo; Luigi Macchia; Giovanni Rolla; Raffaele Brancaccio; Amato De Paulis; Giuseppe Spadaro; Danilo Di Bona; Angela Maria D'Uggento; Lia Ginaldi; Francesco Gaeta; Eleonora Nucera; Kliljeda Jaubashi; Danilo Villalta; Lorenzo Dagna; Domenico Ciotta; Francesco Pucciarini; Diego Bagnasco; Giorgio Celi; Fulvia Chieco Bianchi; Lorenzo Cosmi; Maria Teresa Costantino; Maria Angiola Crivellaro; Simona D'Alò; Pietro Del Biondo; Stefano Del Giacco; Mario Di Gioacchino; Linda Di Pietro; Elisabetta Favero; Sebastiano Gangemi; Gabriella Guarnieri; Enrico Heffler; Maria Stefania Leto Barone; Carla Lombardo; Francesca Losa; Andrea Matucci; Paola Lucia Minciullo; Paola Parronchi; Giovanni Passalacqua; Stefano Pucci; Oliviero Rossi; Lorenzo Salvati; Michele Schiappoli; Gianenrico Senna; Andrea Vianello; Alessandra Vultaggio; Yang Baoran; Cristoforo Incorvaia; Giorgio Walter Canonica Journal: Clin Mol Allergy Date: 2022-05-19