Journal
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
Volume 82, Issue 6, Pages 1328-1336Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jaad.2020.02.060
Keywords
adolescents; adults; atopic dermatitis; CHRONOS; dupilumab; itch; LIBERTY; SOLO
Categories
Funding
- Sanofi
- Regeneron Pharmaceuticals, Inc.
- Regeneron Pharmaceuticals
- Sanofi Genzyme
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Background: Pruritus (itch) is a cardinal symptom in atopic dermatitis (AD). Objective: To evaluate the timing and effect of dupilumab on itch. Methods: Analysis of data from 1505 patients with moderate to severe AD included in 4 randomized controlled studies, treated for up to 52 weeks. Adults received dupilumab 300 mg every 2 weeks or placebo monotherapy (SOLO 1: NCT02277743; SOLO 2: NCT02277769), with concomitant topical corticosteroids (CHRONOS: NCT02260986); adolescents (>= 12 to <18 y) were treated with dupilumab monotherapy every 2 weeks (200 mg for baseline weight of <60 kg; 300 mg for baseline weight of >= 60 kg) or placebo (AD ADOL: NCT03054428). Results: Dupilumab showed significant rapid improvements from baseline in daily Peak Pruritus Numerical Rating Scale scores versus placebo, by day 2 in adults and day 5 in adolescents. At treatment end, dupilumab vs placebo/control had greater least-squares mean percent change from baseline in the weekly average of Peak Pruritus Numerical Rating Scale scores: SOLO -47.5% vs -20.5%; AD-ADOL -47.9% vs -19.0%; CHRONOS -57.3% vs -30.9% (P < .0001 for all). Limitations: Short duration of monotherapy trials (16 weeks). Conclusion: Across 4 randomized trials, dupilumab treatment showed rapid and sustained improvements in the magnitude of itch, starting with first dose; responses progressively increased and were sustained through to the end of treatment, up to 1 year.
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