Effect of Dupilumab on Mental Health Symptoms in Moderate-to-Severe Atopic Dermatitis

Atopic Dermatitis on the diagnosis list, medical concept

Patients with atopic dermatitis are more likely to have symptoms of anxiety and depression and are at a greater risk of suicide. Dupilumab is indicated for treatment of certain patients with atopic dermatitis. A study that was published as part of the AAAAI Annual Meeting assessed the effect of dupilumab on anxiety and depression in adults and adolescents with moderate-to-severe atopic dermatitis.

This was a review of three phase III clinical trials: LIBERTY AD SOLO 1, LIBERTY AD SOLO 2 (adults), and ADOL (adolescents). In both SOLO trials, patients received dupilumab 300 mg weekly (qw) or every two weeks (q2w) or placebo. In ADOL, patients received 200/300 mg q2w, dupilumab 300 mg every four weeks (q4w), or placebo. Hospital Anxiety and Depression Scale (HADS) subscales for anxiety (HADS-A) and depression (HADS-D) were used to assess anxiety and depression outcomes, respectively, with a score of ≥8 or suggesting symptoms of anxiety/depression.

Baseline total HADS scores for adults and adolescents did not largely differ among the treatment groups. Among adults, least-squares mean change in total HADS at week 16 was –5.5 for qw, –5.1 for q2w, and –1.6 for placebo. For adolescents, the respective values were –3.8, –5.2, and –2.5. Patients with baseline HADS-A/HADS-D score ≥8 who received dupilumab were more likely to have scores reduced to <8 by week 16 compared with those who received placebo. Patients with baseline HADS-A or HADS-D score ≥8 who received dupilumab had greater reductions in HADS-A and HADS-D scores to <8 compared with placebo-treated patients.

The study authors concluded that dupilumab monotherapy was beneficial for adult and adolescent patients with atopic dermatitis with symptoms of anxiety and depression, was well tolerated, and had an acceptable safety profile.

https://www.jacionline.org/article/S0091-6749(19)31970-0/fulltext