Drug survival analysis of dupilumab and associated predictors in patients with atopic dermatitis in South Korea: single-center, retrospective study.

Dupilumab is a biologic medication that is used for the treatment of moderate-to-severe atopic dermatitis (AD). Long-term data on dupilumab drug survival in Asia patients with AD are limited. A single-center, retrospective study was performed to assess drug survival between March 2019 and March 2023. Drug survival and associated characteristics were analyzed using Kaplan-Meier survival curves and multivariate Cox regression analysis, respectively. A total of 124 patients with AD (Mean age [standard deviation], 26.0 [8.6] years) with a 4 years-overall dupilumab drug survival rate of 87.9%, were included in this study. Characteristics associated with shorter drug survival were the low eczema area and severity index (EASI) scores at baseline (hazard ratio [HR] 0.84; 95% confidence interval [CI] 0.75-0.94, p-value = 0.003) and non-insurance coverage of dupilumab (HR 11.87; 95% CI 3.28-42.99, p-value = 0.001). This retrospective study demonstrated good overall 4-year dupilumab survival (87.6%) in South Korea. Patients with low baseline EASI scores and those who did not have insurance for dupilumab treatment discontinued the therapy frequently. To the best of our knowledge, this is the first long-term dupilumab drug survival study conducted in Asia with predictors.

Preliminary Clinical Study of the Effects and Safety of 308-nm Excimer Light Treatment in Patients with Atopic Dermatitis.

BACKGROUND: Atopic dermatitis (AD) is a common skin disease which, depending on its severity, can have a significant impact on the quality of life of affected individuals. In cases of severe AD, systemic immunomodulatory agents can be considered for treatment. However, the available treatment options for moderate AD are limited. According to previous reports, however, 308-nm excimer light is a potential treatment for localized, moderate AD. OBJECTIVE: This study aimed to assess the clinical efficacy and safety of 308-nm excimer light in Korean adults with AD. METHODS: This study included Korean patients aged over 19 years, who were diagnosed with AD by a dermatologist, with bilateral, symmetric, and eczematous lesions. The symmetrical lesions in each patient were treated as control-test pairs. Treatment with 308-nm excimer light was applied to the test lesion twice a week for 4 weeks. The severity of the eczema, trans-epidermal water loss, and epidermal capacitance were measured. RESULTS: A total of 25 participants were enrolled in the study. After the first visit, two participants withdrew, whereas the remaining 23 completed the study. There was a statistically significant improvement in AD severity in the test group than in the control group (p<0.001). Skin barrier function also improved in the test than in the control group (p<0.01). CONCLUSION: This study provides preliminary evidence for the use of 308-nm excimer light as a treatment option to improve symptoms and skin barrier function in moderately localized AD.

Periorbital Skin Rejuvenation of Asian Skin Using Microneedle Fractional Radiofrequency.

BACKGROUND: The periorbital area plays an important role cosmetically. Periorbital wrinkles are attributed to long-term, repeated use of orbicularis oris muscles and UV-induced dermal collagen degeneration. Fractional microneedle radiofrequency (RF) treats scars and laxity by creating vertical channels of injury in the dermis, triggering a scarless healing cascade and neocollagenesis. OBJECTIVE: To evaluate the effect and safety of a novel fractional microneedle RF device on periorbital wrinkles based on several objective indicators. METHODS: Eleven healthy Korean patients aged 30 to 75 years with periorbital wrinkles were included in this study. Wrinkle grades were evaluated using the Fitzpatrick wrinkle assessment scale (WAS). The melanin and erythema index, transepidermal water loss (TEWL), and three parameters for elasticity were recorded. Skin biopsies were obtained in patients who consented. RESULTS: All patients exhibited wrinkle improvement in the lateral periorbital area, and two patients also showed efficacy in the lower eyelid area. There was a statistically significant decrease in WAS and a significant improvement in the melanin index of V4 and V5. TEWL also showed a considerable decline on V4 and V5, suggesting that the water content of the skin increased with repeated laser sessions. A peak increase in viscoelasticity and a decrease in retraction time following the first laser application were observed. In the histopathologic examination, the dermis had a denser collagen and elastin content. CONCLUSION: Microneedle fractional RF resulted in statistically significant long-term clinical improvement of periorbital wrinkles and enhanced pigmentation and skin hydration.