日本特应性皮炎患者停用杜必鲁单抗后仅使用外用疗法维持缓解的可能性及其在现实世界中的特点

IF 3.5 3区 医学 Q1 DERMATOLOGY
Ayu Watanabe, Masahiro Kamata, Yoshiki Okada, Shoya Suzuki, Makoto Ito, Hideaki Uchida, Chika Chijiwa, Shota Egawa, Azusa Hiura, Saki Fukaya, Kotaro Hayashi, Atsuko Fukuyasu, Takamitsu Tanaka, Takeko Ishikawa, Yayoi Tada
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引用次数: 0

摘要

停用杜匹单抗治疗特应性皮炎(AD)的可能性和适当时机仍不明确。我们探讨了在现实世界中,有哪些患者在停用杜必鲁单抗后,仅靠局部治疗就能维持缓解。此外,我们还确定了他们的特征。本研究纳入了 2018 年 6 月至 2022 年 7 月期间在我院开始使用杜比单抗并接受杜比单抗治疗 3 个月以上的所有成人 AD 患者。观察期为 2018 年 6 月至 2023 年 7 月。138 名患者中,有 58 人(42.0%)至少停用过一次杜比鲁单抗。其中,18 名患者(13.0%)停用了杜比鲁单抗,但后来因病情加重而重新开始使用杜比鲁单抗。只有 7 名患者(5.1%)在停用杜必鲁单抗后能仅通过局部治疗维持缓解,其特点是基线时 POEM、瘙痒 VAS、血清 TARC 和 LDH 水平以及中性粒细胞计数较低,停用杜必鲁单抗前的持续时间较长(24.0 ± 13.3 对 12.8 ± 7.3 个月),停用杜必鲁单抗时 EASI 和受影响的 BSA 较低。在接受杜比鲁单抗治疗至少一年的 118 名患者中,有 38 名患者(32.2%)至少停药一次。只有 4 名患者(3.4%)在停用杜比鲁单抗后能仅通过局部治疗维持缓解,其特征是基线 POEM 较低,停用杜比鲁单抗时 EASI 较低。总之,停用杜必鲁单抗后维持缓解具有挑战性。基线 POEM 较低的患者在接受了 2 年以上的杜比单抗治疗后,EASI 大幅下降,可以考虑停用杜比单抗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Possibility of maintaining remission with topical therapy alone after withdrawal of dupilumab in Japanese patients with atopic dermatitis and their characteristics in the real world

Psossibility and appropriate timing of discontinuation of dupilumab for atopic dermatitis (AD) remain unclear. We explored the possibility of patients, who could maintain remission with topical therapy alone after withdrawing dupilumab in the real world. Furthermore, we identified their characteristics. All adult AD patients who initiated dupilumab from June 2018 to July 2022 and were treated with dupilumab for more than 3 months at our hospital were included in this study. The observation period was from June 2018 to July 2023. In 138 patients, 58 (42.0%) discontinued dupilumab at least once. Among them, 18 (13.0%) discontinued dupilumab but reinitiated dupilumab later due to exacerbation. Only seven patients (5.1%) could maintain remission with topical therapy alone after discontinuation of dupilumab, with characteristics of lower POEM, VAS of pruritus, serum levels of TARC and LDH, and neutrophil counts at baseline, and those of longer duration of dupilumab until its discontinuation (24.0 ± 13.3 vs. 12.8 ± 7.3 months) and lower EASI and affected BSA at the discontinuation of dupilumab. In 118 patients treated with dupilumab for at least 1 year, 38 patients (32.2%) discontinued at least once. Only four patients (3.4%) could maintain remission with topical therapy alone after discontinuation of dupilumab, with characteristics of lower POEM at baseline and lower EASI at the discontinuation of dupilumab. In conclusion, maintaining remission after withdrawing dupilumab is challenging. Discontinuation of dupilumab may be considered in patients with low baseline POEM, after more than 2 years of dupilumab treatment, with a substantial decrease in EASI.

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来源期刊
Experimental Dermatology
Experimental Dermatology 医学-皮肤病学
CiteScore
6.70
自引率
5.60%
发文量
201
审稿时长
2 months
期刊介绍: Experimental Dermatology provides a vehicle for the rapid publication of innovative and definitive reports, letters to the editor and review articles covering all aspects of experimental dermatology. Preference is given to papers of immediate importance to other investigators, either by virtue of their new methodology, experimental data or new ideas. The essential criteria for publication are clarity, experimental soundness and novelty. Letters to the editor related to published reports may also be accepted, provided that they are short and scientifically relevant to the reports mentioned, in order to provide a continuing forum for discussion. Review articles represent a state-of-the-art overview and are invited by the editors.
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