The clinical relevance of dupilumab serum concentration in patients with atopic dermatitis: a two-center prospective cohort study.
J Dermatolog Treat
; 34(1): 2193663, 2023 Dec.
Article
em En
| MEDLINE
| ID: mdl-37098906
ABSTRACT
BACKGROUND:
Dupilumab is prescribed in one dosage across adult atopic dermatitis patients. Differences in drug exposure may explain variation in treatment response.OBJECTIVE:
Investigating the clinical relevance of dupilumab serum concentration in atopic dermatitis in real-world practice.METHODS:
In two centers (Netherlands, UK), adults treated with dupilumab for atopic dermatitis were evaluated for effectiveness and safety pretreatment and at 2, 12, 24, and 48 weeks; trough serum samples were analyzed for dupilumab concentration at corresponding time points.RESULTS:
In 149 patients, median dupilumab levels during follow-up ranged from 57.4 to 72.4 µg/mL. Levels showed high inter-patient and low intra-patient variability. No correlation was found between levels and ΔEASI. At 2 weeks, levels of ≥64.1 µg/mL predict EASI ≤7 at 24 weeks (specificity100%, sensitivity60%; p = .022). At 12 weeks, ≤32.7 µg/mL predicts EASI >7 at 24 weeks (sensitivity95%, specificity26%; p = .011). Inverse correlations were found between baseline EASI and levels at 2, 12, and 24 weeks (r = -0.25 to 0.36; p ≤ .023). Low levels were particularly observed in patients with adverse events, treatment interval deviation, and discontinuation.CONCLUSION:
At the on-label dosage, the measured range of dupilumab levels does not seem to yield differences in treatment effectiveness. However, disease activity does seem to influence dupilumab levels - higher baseline disease activity results in lower levels at follow-up.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Dermatite Atópica
Tipo de estudo:
Clinical_trials
/
Etiology_studies
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Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Limite:
Adult
/
Humans
Idioma:
En
Revista:
J Dermatolog Treat
Assunto da revista:
DERMATOLOGIA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Holanda