Is Dupilumab Beneficial for Treatment of Erythrodermic Atopic Dermatitis?

Significant improvements reported in percentage BSA affected by AD, Eczema Area and Severity Index score, Peak Pruritus Numerical Rating Scale score

By Dermsquared Editorial Team | February 01, 2023

For patients with erythrodermic atopic dermatitis (AD), treatment with dupilumab results in rapid, sustained improvements in signs and symptoms of AD, according to a study published online Feb. 1 in JAMA Dermatology .

Amy S. Paller, M.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues conducted a post-hoc analysis of patients enrolled in six randomized trials. Patients met erythrodermic AD criteria of 90 percent or greater body surface area (BSA) affected by AD and a Global Individual Sign Score of 1 or greater for erythema.

Overall, 209 of 3,075 randomly assigned patients met the criteria for erythrodermic AD at baseline. The researchers found that compared with placebo, dupilumab once weekly and every two weeks significantly improved the percentage BSA affected by AD (least squares mean percent change, –42.0 and –39.9 versus –17.2 percent with monotherapy; –63.2 and –56.1 versus –14.5 percent with concomitant topical corticosteroids [TCS]), the Eczema Area and Severity Index score (–58.5 and –58.3 versus –22.3 percent with monotherapy; –78.9 and –70.6 versus –19.3 percent with concomitant TCS), and the Peak Pruritus Numerical Rating Scale score (–45.9 and –33.9 versus –0.6 percent with monotherapy; –53.0 and –55.7 versus –26.0 percent with concomitant TCS). As early as week 1, nominally statistically significant improvement was seen. Significant reduction in biomarker levels was seen compared with placebo.

Several authors disclosed financial ties to biopharmaceutical companies, including Sanofi and Regeneron, which manufacture dupilumab and funded the study.

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