High loading-dose of dupilumab resulted in rapid disease control in pediatric patients with atopic dermatitis
BackgroundThe real-world experience of dupilumab in Chinese is limited, and the initial loading dose has not yet been deeply explored in patients aged <6 years.ObjectiveTo explore the efficacy and safety of dupilumab in Chinese patients with moderate-to-severe atopic dermatitis and investigat...
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| Format: | Article |
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1160710/full |
| _version_ | 1797843765859188736 |
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| author | Ao Wang Yuan Zhou Yang Luo Yingxia Gao Jingsi Chen Jingsi Chen Wei Li Xiaoyan Luo Xiaoyan Luo Xu Yao |
| author_facet | Ao Wang Yuan Zhou Yang Luo Yingxia Gao Jingsi Chen Jingsi Chen Wei Li Xiaoyan Luo Xiaoyan Luo Xu Yao |
| author_sort | Ao Wang |
| collection | DOAJ |
| description | BackgroundThe real-world experience of dupilumab in Chinese is limited, and the initial loading dose has not yet been deeply explored in patients aged <6 years.ObjectiveTo explore the efficacy and safety of dupilumab in Chinese patients with moderate-to-severe atopic dermatitis and investigate the effect of higher loading dose for disease control in patients aged <6 years.MethodsA total of 155 patients were divided into three groups according to age: <6 years, 6-11 years, and >11 years. Among patients aged <6 years, 37 patients received a high loading dose of 300 mg for body weight <15kg or 600 mg for body weight ≥15kg, and another 37 patients received a standard loading dose of 200 mg for body weight <15kg or 300 mg for body weight ≥15kg. Multiple physicians and patient-reported outcome measures were evaluated at baseline and 2, 4, 6, 8, 12, and 16 weeks after dupilumab treatment.ResultsThe proportion of patients showing an improvement of ≥75% in the Eczema Area and Severity Index was 68.0% (17/25), 76.9% (10/13), and 62.5% (25/40) in the aged <6, 6-11, and >11 years groups, respectively, at week 16. After increasing the loading dose, 69.6% (16/23) of patients aged <6 years achieved 4-point improvement in Pruritus Numerical Rating Scale at week 2, compared with 23.5% (8/34) of patients receiving standard loading dose (P < 0.001). Obesity (odds ratio=0.12, 95% confidence interval: 0.02-0.70) was predictive of a poor response to dupilumab treatment, while female (odds ratio=3.94, 95% confidence interval: 1.26-12.31) predicted good response at week 16. The change of serum C-C motif ligand 17(CCL17/TARC) could reflect the response to dupilumab (r = 0.53, P = 0.002 in EASI) among patients aged <18 years. No major adverse events were reported during the treatment.ConclusionsDupilumab was effective and well-tolerated in Chinese patients with atopic dermatitis. The increased loading dose helped achieve rapid pruritus control in patients aged <6 years. |
| first_indexed | 2024-04-09T17:11:14Z |
| format | Article |
| id | doaj.art-362a6af42dba4b78b7478ee69e4b8e2b |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-04-09T17:11:14Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Immunology |
| spelling | doaj.art-362a6af42dba4b78b7478ee69e4b8e2b2023-04-20T05:53:28ZengFrontiers Media S.A.Frontiers in Immunology1664-32242023-04-011410.3389/fimmu.2023.11607101160710High loading-dose of dupilumab resulted in rapid disease control in pediatric patients with atopic dermatitisAo Wang0Yuan Zhou1Yang Luo2Yingxia Gao3Jingsi Chen4Jingsi Chen5Wei Li6Xiaoyan Luo7Xiaoyan Luo8Xu Yao9Department of Allergy and Rheumatology, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, ChinaDepartment of Allergy and Rheumatology, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, ChinaDepartment of Allergy and Rheumatology, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, ChinaDepartment of Allergy and Rheumatology, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, ChinaDepartment of Dermatology, Children’s Hospital of Chongqing Medical University, Chongqing, ChinaNational Clinical Research Center for Child Health and Disorders, Ministry of Education Key laboratory of Child Development and Disorders, Chongqing, ChinaDepartment of Dermatology, Huashan Hospital, Fudan University, Shanghai, ChinaDepartment of Dermatology, Children’s Hospital of Chongqing Medical University, Chongqing, ChinaNational Clinical Research Center for Child Health and Disorders, Ministry of Education Key laboratory of Child Development and Disorders, Chongqing, ChinaDepartment of Allergy and Rheumatology, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, ChinaBackgroundThe real-world experience of dupilumab in Chinese is limited, and the initial loading dose has not yet been deeply explored in patients aged <6 years.ObjectiveTo explore the efficacy and safety of dupilumab in Chinese patients with moderate-to-severe atopic dermatitis and investigate the effect of higher loading dose for disease control in patients aged <6 years.MethodsA total of 155 patients were divided into three groups according to age: <6 years, 6-11 years, and >11 years. Among patients aged <6 years, 37 patients received a high loading dose of 300 mg for body weight <15kg or 600 mg for body weight ≥15kg, and another 37 patients received a standard loading dose of 200 mg for body weight <15kg or 300 mg for body weight ≥15kg. Multiple physicians and patient-reported outcome measures were evaluated at baseline and 2, 4, 6, 8, 12, and 16 weeks after dupilumab treatment.ResultsThe proportion of patients showing an improvement of ≥75% in the Eczema Area and Severity Index was 68.0% (17/25), 76.9% (10/13), and 62.5% (25/40) in the aged <6, 6-11, and >11 years groups, respectively, at week 16. After increasing the loading dose, 69.6% (16/23) of patients aged <6 years achieved 4-point improvement in Pruritus Numerical Rating Scale at week 2, compared with 23.5% (8/34) of patients receiving standard loading dose (P < 0.001). Obesity (odds ratio=0.12, 95% confidence interval: 0.02-0.70) was predictive of a poor response to dupilumab treatment, while female (odds ratio=3.94, 95% confidence interval: 1.26-12.31) predicted good response at week 16. The change of serum C-C motif ligand 17(CCL17/TARC) could reflect the response to dupilumab (r = 0.53, P = 0.002 in EASI) among patients aged <18 years. No major adverse events were reported during the treatment.ConclusionsDupilumab was effective and well-tolerated in Chinese patients with atopic dermatitis. The increased loading dose helped achieve rapid pruritus control in patients aged <6 years.https://www.frontiersin.org/articles/10.3389/fimmu.2023.1160710/fullatopic dermatitisCCL17/TARCchildrendupilumabobesity |
| spellingShingle | Ao Wang Yuan Zhou Yang Luo Yingxia Gao Jingsi Chen Jingsi Chen Wei Li Xiaoyan Luo Xiaoyan Luo Xu Yao High loading-dose of dupilumab resulted in rapid disease control in pediatric patients with atopic dermatitis Frontiers in Immunology atopic dermatitis CCL17/TARC children dupilumab obesity |
| title | High loading-dose of dupilumab resulted in rapid disease control in pediatric patients with atopic dermatitis |
| title_full | High loading-dose of dupilumab resulted in rapid disease control in pediatric patients with atopic dermatitis |
| title_fullStr | High loading-dose of dupilumab resulted in rapid disease control in pediatric patients with atopic dermatitis |
| title_full_unstemmed | High loading-dose of dupilumab resulted in rapid disease control in pediatric patients with atopic dermatitis |
| title_short | High loading-dose of dupilumab resulted in rapid disease control in pediatric patients with atopic dermatitis |
| title_sort | high loading dose of dupilumab resulted in rapid disease control in pediatric patients with atopic dermatitis |
| topic | atopic dermatitis CCL17/TARC children dupilumab obesity |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1160710/full |
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