No Increased Risk of Overall Infection in Adults with Moderate-to-Severe Atopic Dermatitis Treated for up to 4 Years with Dupilumab

Blauvelt, Andrew; Wollenberg, Andreas; Eichenfield, Lawrence F.; Zhang, Haixin; Sierka, Debra; Khokhar, Faisal A.; Vakil, Jignesh; Shabbir, Arsalan; Marco, Ainara Rodriguez und Cyr, Sonya L. (2022): No Increased Risk of Overall Infection in Adults with Moderate-to-Severe Atopic Dermatitis Treated for up to 4 Years with Dupilumab. In: Advances in Therapy, Bd. 40, Nr. 1: S. 367-380

Abstract

Introduction: Patients with atopic dermatitis (AD) have an increased risk for infections. This open-label extension study, LIBERTY AD OLE, reports the incidence of infections in adults with moderate-to-severe AD treated with dupilumab for up to 4 years. Methods: We evaluated infections in adults with moderate-to-severe AD treated with dupilumab 300 mg weekly (qw) or every 2 weeks (q2w;approved regimen) for up to 4 years. Topical corticosteroids (TCS) and calcineurin inhibitors (TCI) were permitted. Exposure-adjusted incidence rates (number of patients with at least one event per 100 patient-years [nP/100 PY]) are reported. Results: Overall, 2677 patients were enrolled and treated with dupilumab: 352 (13.1%) completed up to week 204;226 patients (8.4%) switched from qw to q2w during the trial. Rates of overall infections (71.27 nP/100 PY), serious and/or severe infections (1.39 nP/100 PY), and infections leading to discontinuation (0.34 nP/100 PY) were consistent with a previous 3-year analysis of this study and low compared with 1-year results in adults with AD treated with placebo + TCS. The cumulative number of patients with treatment-emergent serious or severe infections, non-herpetic or herpetic infections, and total skin infections decreased year-over-year. Limitations included open-label study design with no placebo arm;decreasing sample size at later time points due to sponsor decision to close sites following regulatory approval;qw dosing differs from approved q2w dosing;and patients could use TCS/TCI throughout the study, which may have impacted infection rates. Conclusions: Continuous long-term dupilumab treatment in adults with moderate-to-severe AD is not associated with an increased risk of overall systemic or cutaneous infections. Infographic [GRAPHICS] PLAIN LANGUAGE SUMMARY Atopic dermatitis is a chronic disease that causes dry skin, skin inflammation, and itching. Patients with atopic dermatitis have an increased risk of bacterial or viral skin infections, which can cause further serious infections in the entire body. This study investigated the rates of infections in adults with moderate-tosevere atopic dermatitis after 204 weeks (almost 4 years) of dupilumab treatment. The patients received 300 mg of dupilumab every week, and a subset of patients switched to the approved dose of 300 mg of dupilumab every 2 weeks. Patients were allowed the use of topical corticosteroids. Among the patients receiving dupilumab for up to 4 years, rates of total infections, serious and severe infections, and infections leading to treatment discontinuation were consistent with a previously published 3-year evaluation. The infection rates in the 4-year study were lower than those in a previous 1-year study in adults with atopic dermatitis treated with placebo and topical corticosteroids. Importantly, our results showed that the cumulative number of patients with total skin infections decreased over 4 years of dupilumab treatment. The number of patients with severe infections appearing after the start of treatment, herpes viral infections, and infections not involving herpes virus also decreased yearly during the 4-year study. The safety data presented here show that long-term dupilumab treatment does not increase the overall risk of skin infections, and provides important evidence related to continuous use of dupilumab treatment in adults with moderate-to-severe atopic dermatitis.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0741-238X
• Sprache: Englisch