Dupilumab Versus Cyclosporine for the Treatment of Moderate-to-Severe Atopic Dermatitis in Adults: Indirect Comparison Using the Eczema Area and Severity Index

Dupilumab Versus Cyclosporine for the Treatment of Moderate-to-Severe Atopic Dermatitis in Adults: Indirect Comparison Using the Eczema Area and Severity Index

Dupilumab is approved for uncontrolled moderate-to-severe atopic dermatitis (AD); cyclosporine is approved for severe AD for <1 year. The efficacy/effectiveness of these treat­ments was compared indirectly. Regression models used pooled patient-level data to estimate response (Eczema Area and Sev...

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Bibliographic Details
Main Authors: Lieneke F.M. Ariëns, Abhijit Gadkari, Harmieke van Os-Medendorp, Rajeev Ayyagari, Emi Terasawa, Andreas Kuznik, Zhen Chen, Gaëlle Bégo-Le Bagousse, Yufang Lu, Elena Rizova, Neil M.H. Graham, Gianluca Pirozzi, Marjolein De Bruin-Weller, Laurent Eckert
Format: Article
Language:English
Published: Medical Journals Sweden 2019-06-01
Series:Acta Dermato-Venereologica
Subjects:
adult
atopic dermatitis
cyclosporine
dupilumab
Eczema Area and Severity Index
eczema
Online Access: https://www.medicaljournals.se/acta/content/html/10.2340/00015555-3219
Description
Summary:Dupilumab is approved for uncontrolled moderate-to-severe atopic dermatitis (AD); cyclosporine is approved for severe AD for <1 year. The efficacy/effectiveness of these treat­ments was compared indirectly. Regression models used pooled patient-level data to estimate response (Eczema Area and Severity Index (EASI) EASI-50/EASI-75 at weeks 12–16 and 24–30) to dupilumab 300 mg every 2 weeks (CHRONOS [NCT02260986]) or cyclosporine (University Medical Center). Models were adjusted for sex, baseline EASI, and thymus and activation-regulated chemokine level. A total of 106 patients received dupilumab (+ topical cortico­steroids; + TCS), and 57 received cyclosporine (+ TCS). Among University Medical Center patients, estimated EASI-50 responders were, dupilumab vs. cyclosporine, 91% vs. 77% (p = 0.038; weeks 12–16), and 96% vs. 67% (p <0.0001; weeks 24–30); EASI-75 responders were 78% vs. 56% (p = 0.016; weeks 12–16) and 80% vs. 47% (p <0.001; weeks 24–30). Among CHRONOS patients, estimated EASI-50 responders were 90% vs. 74% (p <0.038; weeks 12–16) and 92% vs. 53% (p < 0.0001; weeks 24–30); EASI-75 responders were 75% vs. 52% (p = 0.016; weeks 12–16) and 74% vs. 40% (p <0.001; weeks 24–30), respectively. These results suggest a higher relative efficacy of dupilumab vs. cyclosporine.
ISSN:0001-5555
1651-2057

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