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Treatment outcomes of patients with Atopic Dermatitis (AD) treated with dupilumab through the Early Access to Medicines Scheme (EAMS) in the UK

Treatment outcomes of patients with Atopic Dermatitis (AD) treated with dupilumab through the Early Access to Medicines Scheme (EAMS) in the UK
Treatment outcomes of patients with Atopic Dermatitis (AD) treated with dupilumab through the Early Access to Medicines Scheme (EAMS) in the UK

BACKGROUND Dupilumab, a monoclonal antibody against interleukin (IL)-4 receptor alpha that inhibits IL-4/IL-13 signalling is indicated in dermatology for the treatment of moderate-to-severe atopic dermatitis (AD) in adult and adolescent patients 12 years and older and severe AD in children 6-11 years, who are candidates for systemic therapy. Dupilumab received Early Access to Medicines Scheme (EAMS) approval for adults in March 2017. OBJECTIVES The purpose of this study was to assess the efficacy outcomes of treatment with dupilumab in EAMS. METHODS A retrospective analysis of adult patients enrolled in the dupilumab EAMS in the UK. Scores were assessed at baseline and follow up, including the Eczema Area and Severity Index (EASI), Investigator’s Global Assessment Score (IGA) and Dermatology Life Quality Index (DLQI). RESULTS Data were available for 57 adult patients treated with dupilumab for at least 12 weeks; 73.6% of patients had received prior treatment with 3 or 4 immunosuppressants. Baseline scores for the EASI and DLQI were 27.93 (standard deviation, SD 13.09) and 18.26 (SD 6.18) respectively. AD severity scores showed statistically significant improvement at week 16+4 weeks (p <0.001 for all). The mean change in EASI was 14.13 points with 66.7% and 36.7% achieving a 50% (EASI-50) and 75% (EASI-75) improvement in EASI, respectively at 16 +/- 4 weeks. IGA scores improved by at least two categories for 75% patients. DLQI scores decreased by a mean of 9.0 points, with 80% patients demonstrating a MCID 4-point improvement. For 85% patients, clinicians rated the treatment response as being either ‘better’ (19%) or ‘much better’ (65%). CONCLUSIONS Dupilumab is associated with a significant and clinically relevant improvements in AD as measured by patient-and physician-reported outcome measures. Importantly, the clinical efficacy, despite the refractory disease of this EAMS cohort, is comparable to that previously reported in clinical trials.

0041-6193
70-76
Ardern-Jones, Michael
7ac43c24-94ab-4d19-ba69-afaa546bec90
Ardern-Jones, Michael
7ac43c24-94ab-4d19-ba69-afaa546bec90

Ardern-Jones, Michael (2021) Treatment outcomes of patients with Atopic Dermatitis (AD) treated with dupilumab through the Early Access to Medicines Scheme (EAMS) in the UK. Ulster Medical Journal, 90 (2), 70-76. (In Press)

Record type: Article

Abstract

BACKGROUND Dupilumab, a monoclonal antibody against interleukin (IL)-4 receptor alpha that inhibits IL-4/IL-13 signalling is indicated in dermatology for the treatment of moderate-to-severe atopic dermatitis (AD) in adult and adolescent patients 12 years and older and severe AD in children 6-11 years, who are candidates for systemic therapy. Dupilumab received Early Access to Medicines Scheme (EAMS) approval for adults in March 2017. OBJECTIVES The purpose of this study was to assess the efficacy outcomes of treatment with dupilumab in EAMS. METHODS A retrospective analysis of adult patients enrolled in the dupilumab EAMS in the UK. Scores were assessed at baseline and follow up, including the Eczema Area and Severity Index (EASI), Investigator’s Global Assessment Score (IGA) and Dermatology Life Quality Index (DLQI). RESULTS Data were available for 57 adult patients treated with dupilumab for at least 12 weeks; 73.6% of patients had received prior treatment with 3 or 4 immunosuppressants. Baseline scores for the EASI and DLQI were 27.93 (standard deviation, SD 13.09) and 18.26 (SD 6.18) respectively. AD severity scores showed statistically significant improvement at week 16+4 weeks (p <0.001 for all). The mean change in EASI was 14.13 points with 66.7% and 36.7% achieving a 50% (EASI-50) and 75% (EASI-75) improvement in EASI, respectively at 16 +/- 4 weeks. IGA scores improved by at least two categories for 75% patients. DLQI scores decreased by a mean of 9.0 points, with 80% patients demonstrating a MCID 4-point improvement. For 85% patients, clinicians rated the treatment response as being either ‘better’ (19%) or ‘much better’ (65%). CONCLUSIONS Dupilumab is associated with a significant and clinically relevant improvements in AD as measured by patient-and physician-reported outcome measures. Importantly, the clinical efficacy, despite the refractory disease of this EAMS cohort, is comparable to that previously reported in clinical trials.

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Accepted/In Press date: 29 March 2021

Identifiers

Local EPrints ID: 454418
URI: http://eprints.soton.ac.uk/id/eprint/454418
ISSN: 0041-6193
PURE UUID: 83605ede-30f1-4776-a924-d08e7ddcee26
ORCID for Michael Ardern-Jones: ORCID iD orcid.org/0000-0003-1466-2016

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Date deposited: 09 Feb 2022 17:33
Last modified: 17 Mar 2024 03:10

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