Efficacy of Dupilumab on Pruritus in Moderate-to-Severe Atopic Dermatitis

Woman scratching her itchy back with allergy rash, Concept with Healthcare And Medicine.

Patients with atopic dermatitis may experience poorer quality of life due to intense pruritus caused by their disease, making pruritus an important consideration for treatment. Several trials focused on the effect of dupilumab on pruritus in adult and adolescent patients with atopic dermatitis and found it was superior compared with placebo. The results were published as part of the AAAAI Annual Meeting.

Adult patients in the LIBERTY AD SOLO 1 and 2 trials received dupilumab 300 mg weekly (qw) or every two weeks (q2w), or placebo. Adolescent patients in the ADOL trial received dupilumab 200 mg or 300 mg q2w, 300 mg every four weeks (q4w), or placebo. The present study was a post-hoc analysis of daily change in Peak Pruritus Numerical Rating Scale (NRS) score from baseline to day 15.

Baseline characteristics among the groups did not largely differ, but adolescents had higher disease severity. Baseline Peak Pruritus NRS scores (standard deviation) in adults were: qw, 7.3 (1.9); q2w, 7.4 (1.8); and placebo, 7.4 (1.8); in adolescents, baseline Peak Pruritus NRS scores were: q2w, 7.5 (1.5); q4w, 7.5 (1.8); and placebo, 7.7 (1.6). In adults, dupilumab treatment improved pruritis significantly compared with placebo as early as day two (P≤0.003), and in adolescents, improvements were observed at day six (P<0.01), per least squares (LS) mean percentage change in Peak Pruritus NRS score. After 15 days, LS mean percent change (standard error) in adults was: qw, −22.5 (1.4); q2w, −24.7 (1.4); and placebo, −3.4 (1.4; P<0.0001 for both doses); for adolescents, LS mean percent change was: q2w, −25.3 (2.7); q4w, −21.8 (2.7); and placebo, −5.7 (2.6; P<0.0001 for both doses). Overall, dupilumab presented an acceptable safety profile and was well-tolerated.

The researchers concluded that dupilumab provided “rapid improvement” in pruritus in adults and adolescents with moderate-to-severe atopic dermatitis.

https://www.jacionline.org/article/S0091-6749(19)31967-0/fulltext