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Stingeni L, Bianchi L, Antonelli E, Caroppo ES, Ferrucci SM, Ortoncelli M, Fabbrocini G, Nettis E, Schena D, Napolitano M, Gola M, Bonzano L, Rossi M, Belloni Fortina A, Balato A, Peris K, Foti C, Guarneri F, Romanelli M, Patruno C, Savoia P, Fargnoli MC, Russo F, Errichetti E, Bianchelli T, Bianchi L, Pellacani G, Feliciani C, Offidani A, Corazza M, Micali G, Milanesi N, Malara G, Chiricozzi A, Tramontana M, Hansel K, Bini V, Buligan C, Caroppo F, Bello GD, Dastoli S, De Brizi EV, Del Giudice MBDF, Diluvio L, Esposito M, Gelmetti A, Giacchetti A, Grieco T, Iannone M, Macchia L, Marietti R, Musumeci ML, Peccerillo F, Pluchino F, Radi G, Ribero S, Romita P, Tavecchio S, Tronconi G, Veronese F. Moderate to severe atopic dermatitis in adolescents treated with dupilumab: a multicenter Italian real-world experience. J Eur Acad Dermatol Venereol 2022; 36:1292-1299. [PMID: 35412683 PMCID: PMC9542087 DOI: 10.1111/jdv.18141] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 02/12/2022] [Accepted: 03/23/2022] [Indexed: 11/26/2022]
Abstract
Background Moderate‐to‐severe atopic dermatitis (AD) in the adolescence is a high burden disease, and its treatment can be very challenging due to paucity of approved systemic drugs for this age and their side‐effects. Dupilumab was recently approved for treatment of adolescent AD. Objectives A multicentre, prospective, real‐world study on the effectiveness and safety of dupilumab in adolescents (aged from ≥12 to <18 years) with moderate‐to‐severe AD was conducted. The main AD clinical phenotypes were also examined. Methods Data of adolescents with moderate‐to‐severe AD treated with dupilumab at label dosage for 16 weeks were collected. Treatment outcome was assessed by EASI, NRS itch, NRS sleep loss and CDLQI scores at baseline and after 16 weeks of treatment. The clinical scores were also evaluated according to clinical phenotypes. Results One hundred and thirty‐nine adolescents were enrolled in the study. Flexural eczema and head and neck eczema were the most frequent clinical phenotypes, followed by hand eczema and portrait‐like dermatitis. Coexistence of more than 1 phenotype was documented in 126/139 (88.5%) adolescents. Three patients (2.1%) contracted asymptomatic SARS‐CoV‐2 infection and 1 of the discontinued dupilumab treatment before the target treatment period. A significant improvement in EASI, NRS itch, NRS sleep loss and CDLQI was observed after 16 weeks of treatment with dupilumab. This outcome was better than that observed in clinical trials. Dupilumab resulted effective in all AD phenotypes, especially in diffuse eczema. Twenty‐eight (20.1%) patients reported adverse events, conjunctivitis and flushing being the most frequent. None of patients discontinued dupilumab due to adverse event. Conclusions Dupilumab in adolescent AD showed excellent effectiveness at week 16 with consistent improvement of all clinical scores. Moreover, dupilumab showed a good safety profile also in this COVID‐19 pandemic era.
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Affiliation(s)
- L Stingeni
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - L Bianchi
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - E Antonelli
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - E S Caroppo
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - S M Ferrucci
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M Ortoncelli
- Division of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - G Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - E Nettis
- Department of Emergency and Organ Transplantation, Allergology and Clinical Immunology, University of Bari, Bari, Italy
| | - D Schena
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - M Napolitano
- Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy
| | - M Gola
- Unit of Allergological and Pediatric Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - L Bonzano
- Dermatology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - M Rossi
- Department of Dermatology, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - A Belloni Fortina
- Unit of Dermatology, Department of Medicine DIMED, University of Padua, Padua, Italy
| | - A Balato
- Unit of Dermatology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - K Peris
- Institute of Dermatology, Catholic University, Rome, Italy
| | - C Foti
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | - F Guarneri
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - M Romanelli
- Dermatology Unit, University of Pisa, Pisa, Italy
| | - C Patruno
- Section of Dermatology, Health Sciences Department, Magna Graecia University, Catanzaro, Italy
| | - P Savoia
- Dermatology Clinic, Department of Health Science, University of Eastern Piedmont, Novara, Italy
| | - M C Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - F Russo
- Section of Dermatology, Department of Clinical, Surgical Medicine and Neuroscience, University of Siena, Siena, Italy
| | - E Errichetti
- Institute of Dermatology, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - T Bianchelli
- Dermatology Unit, Istituto Nazionale di Riposo e Cura per Anziani, INRCA-IRCCS Hospital, Ancona, Italy
| | - L Bianchi
- Dermatology Unit, System Medicine Department, University of Tor Vergata, Rome, Italy
| | - G Pellacani
- Department of Dermatology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - C Feliciani
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - A Offidani
- Dermatology Clinic, Clinical and Molecular Science Department, Polytechnic Marche University, Ancona, Italy
| | - M Corazza
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - G Micali
- Dermatology Clinic, University of Catania, Catania, Italy
| | - N Milanesi
- Allergological and Occupational Dermatology Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - G Malara
- Dermatology Unit, Grande Ospedale Metropolitano, Reggio Calabria, Italy
| | - A Chiricozzi
- Institute of Dermatology, Catholic University, Rome, Italy
| | - M Tramontana
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - K Hansel
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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