1. Biomarkers and patient-related factors associated with clinical outcomes in dupilumab-treated atopic dermatitis
- Author
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Makiko Kido-Nakahara, MD, Daisuke Onozuka, PhD, Kenji Izuhara, PhD, Hidehisa Saeki, MD, Satoshi Nunomura, PhD, Motoi Takenaka, MD, Mai Matsumoto, MD, Yoko Kataoka, MD, Rai Fujimoto, MD, Sakae Kaneko, MD, Eishin Morita, MD, Akio Tanaka, MD, Michihiro Hide, MD, Tatsuro Okano, MD, Tomomitsu Miyagaki, MD, Natsuko Aoki, MD, Kimiko Nakajima, MD, Susumu Ichiyama, MD, Kyoko Tonomura, MD, Yukinobu Nakagawa, MD, Risa Tamagawa-Mineoka, MD, Koji Masuda, MD, Takuya Takeichi, MD, Masashi Akiyama, MD, Yozo Ishiuji, MD, Michie Katsuta, MD, Yuki Kinoshita, MD, Chiharu Tateishi, MD, Aya Yamamoto, MD, Akimichi Morita, MD, Haruna Matsuda-Hirose, MD, Yutaka Hatano, MD, Hiroshi Kawasaki, MD, Keiji Tanese, MD, Mamitaro Ohtsuki, MD, Koji Kamiya, MD, Yudai Kabata, MD, Riichiro Abe, MD, Hiroshi Mitsui, MD, Tatsuyoshi Kawamura, MD, Gaku Tsuji, MD, Masutaka Furue, MD, Norito Katoh, MD, and Takeshi Nakahara, MD
- Subjects
Atopic dermatitis ,dupilumab ,Eczema Area and Severity Index ,lactate dehydrogenase ,Patient-Oriented Eczema Measure ,periostin ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Background: Atopic dermatitis (AD) is a common chronic eczematous skin disease with severe pruritus. Several new therapeutic agents for AD such as dupilumab, an anti–IL-4Rα antibody, have been developed in recent years. We need to predict which agent is the best choice for each patient, but this remains difficult. Objective: Our aim was to examine clinical background factors and baseline biomarkers that could predict the achievement of improved clinical outcomes in patients with AD treated with dupilumab. Methods: A multicenter, prospective observational study was conducted on 110 patients with AD. The Eczema Area and Severity Index was used as an objective assessment, and the Patient-Oriented Eczema Measure and Numerical Rating Scale for Pruritus were used as patient-reported outcomes. In addition, some clinical background factors were evaluated. Results: The achievement of an absolute Eczema Area and Severity Index of 7 or less was negatively associated with current comorbidity of food allergy and baseline serum lactate dehydrogenase (LDH) levels. There were negative associations between achievement of a Patient-Oriented Eczema Measure score of 7 or less and duration of severe AD and between achievement of an itching Numerical Rating Scale for Pruritus score of 1 or less and current comorbidity of allergic conjunctivitis or baseline serum periostin level. Furthermore, signal detection analysis showed that a baseline serum LDH level less than 328 U/L could potentially be used as a cutoff value for predicting the efficacy of dupilumab. Conclusion: Baseline biomarkers such as LDH and periostin and clinical background factors such as current comorbidity of food allergy and a long period of severe disease may be useful indicators when choosing dupilumab for systemic treatment for AD, as they can predict the efficacy of dupilumab.
- Published
- 2024
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