Are Biologics Efficacious in Atopic Dermatitis? A Systematic Review and Meta-Analysis

Snast, Igor; Reiter, Ofer; Hodak, Emmilia; Friedland, Rivka; Mimouni, Daniel; Leshem, Yael Anne

doi:10.1007/s40257-017-0324-7

Cited by 66 publications

(76 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Ten of the combined 15 (66.7%) patients achieved the greater than 50% improvement threshold for regional or total SCORAD (P = 0.016). Furthermore, the rate of patients achieving 75% clinical improvement (40%) significantly differed from reports of similar improvements attributable to placebo (13.3%; P = 0.04) (23,24). The combined mean improvement for the cohort was 63.9%; responders averaged 84.1% improvement and partial to nonresponders averaged 21.7% improvement.…”

Section: R Mucosa Was Associated With Clinical Improvement and Safetmentioning

confidence: 73%

“…mucosa response associations were significantly greater than reported placebo effects. Noting a historical placebo effect of 5%-30%, past studies have determined that a greater than 50% improvement in SCORAD (SCORAD-50) during treatment is statistically suggestive of treatment activity (21)(22)(23)(24). By these parameters, treatment was associated with response in 4 pediatric patients (mean improvement of -78.4%) with one nonresponder (-38%).…”

Section: R Mucosa Was Associated With Clinical Improvement and Safetmentioning

confidence: 99%

“…A 50% reduction in SCORAD or regional SCORAD (SCORAD-50) was used as per prior publications (21,24,47,48). The placebo response in SCORAD was calculated from placebo control data as approximately 5%-30% over studies lasting 1-12 months (22,24,(49)(50)(51). The natural history of AD suggests that 50%-90% of patents will self-resolve by approximately 12-15 years of age (6,7,25).…”

Section: Sample Size Derivationsmentioning

confidence: 99%

See 2 more Smart Citations

First-in-human topical microbiome transplantation with Roseomonas mucosa for atopic dermatitis

et al. 2018

View full text Add to dashboard Cite

Section: R Mucosa Was Associated With Clinical Improvement and Safetmentioning

confidence: 73%

Section: R Mucosa Was Associated With Clinical Improvement and Safetmentioning

confidence: 99%

Section: Sample Size Derivationsmentioning

confidence: 99%

See 1 more Smart Citation

First-in-human topical microbiome transplantation with Roseomonas mucosa for atopic dermatitis

et al. 2018

View full text Add to dashboard Cite

“…Treatment with emollients and topical anti‐inflammatory agents comprises the cornerstone in the management of mild AD, while systemic treatment with immunosuppressive drugs (i.e. methotrexate, ciclosporin and azathioprine) is frequently required to ensure adequate disease control in patients with moderate‐to‐severe AD, although these drugs are not always effective and associated with frequent side‐effects . Accordingly, the management of recalcitrant AD poses a challenge to dermatologists.…”

Section: Introductionmentioning

confidence: 99%

Treatment of atopic dermatitis with dupilumab: experience from a tertiary referral centre

Olesen

Holm

Nørreslet

et al. 2019

Acad Dermatol Venereol

View full text Add to dashboard Cite

Background Management of moderate‐to‐severe atopic dermatitis (AD) frequently requires treatment with systemic therapies. Dupilumab is the first biological agent approved for treatment of moderate‐to‐severe AD. Although promising results have appeared in clinical trials, real‐life data on efficacy and safety are lacking. Objectives To assess effectiveness and safety of treatment with dupilumab in the real‐life clinical setting at a Danish tertiary referral centre. Methods All patients with AD treated with dupilumab from October 2017 to October 2018 at Bispebjerg Hospital, Denmark, were included in the study. Patients were evaluated three times: at treatment initiation and at 1 and 3 months after first dupilumab injection. At each visit, disease activity was assessed by severity score (Eczema Area and Severity Index, EASI), patient‐reported outcomes (Dermatology Life Quality Index, DLQI, pruritus and sleep score) and serological markers [immunoglobulin (Ig)E, eosinophil count and lactate dehydrogenase (LDH)]. Results A total of 43 patients were included in the study. The mean reduction in EASI score from baseline was 19.6 points (72.4%) at 1‐month and 22.6 points (76.7%) at 3‐month follow‐up. EASI, DLQI, pruritus score, sleep score, IgE and LDH were all statistically significantly reduced between baseline and 1‐ and 3‐month follow‐up. Mean reductions in EASI score and LDH at 3‐month follow‐up were significantly correlated (P = 0.003). One patient (2.3%) discontinued treatment due to side‐effects, and seven patients (18.4%) developed conjunctivitis during the study period. Conclusion The effectiveness and safety of dupilumab treatment in a real‐life clinical setting are comparable to that of phase 3 clinical trials. LDH is suggested as a potential serological marker predictive of treatment response.

show abstract

“…3 Patients with AD commonly have elevated total IgE levels (extrinsic AD). [5][6][7][8][9][10][11] Immunoadsorption (IA), aiming at an immunomodulatory depletion of pathogenic serum mediators, was previously reported to cause disease amelioration paralleled by normalization of cutaneous inflammatory parameters (ie, density of CD3 + , CD4 + , CD1a + cellular infiltrates) in AD patients refractory to multiple conventional treatment strategies including cyclosporine A. 4 Somewhat consistently, data on the clinical efficacy of omalizumab, a recombinant humanized monoclonal antibody targeting the high-affinity Fc receptor of IgE, are conflicting in AD, even when focusing on the subgroup of patients with high IgE levels.…”

Section: Introductionmentioning

confidence: 99%

Single‐use IgE‐selective immunoadsorber column for the treatment of severe atopic dermatitis

Meyersburg

Laimer

Kügler

et al. 2019

J of Clinical Apheresis

View full text Add to dashboard Cite

Background: Atopic dermatitis (AD) is a chronic and relapsing inflammatory skin disease with unmet therapeutic need in a critical cohort of recalcitrant cases. Immunoadsorption (IA) aims at an immunomodulatory depletion of pathogenic serum mediators and has recently revealed promising clinical results for the treatment of AD.Objective: To determine efficacy, sustainability, safety, and clinical impact of IgE selective IA in AD using a single-use IgE immunoadsorber column.Methods: This open-label pilot study comprised five patients (mean SCORAD 67.9 ± 11.4, range 52.2-81.9; mean serum IgE level 5904 ± 5945 U/mL, range 1000-15 600 IU/mL) who underwent IgE-selective IA. Three patients continued prior therapy with systemic immunosuppressive drugs during IA as an add-on therapeutic approach. All patients received three courses of IA. The first course consisted of three consecutive daily treatments followed by two sequences with two consecutive applications. All courses were performed on a monthly regimen.Results: IA proved efficacy in selectively depleting serum IgE levels in all participants (mean reduction by cycle of 81% ± 12%, range 64%-93%). It further led to a clinically relevant and sustained improvement of AD with a maximum decline in SCORAD and EASI scores by up to 35% and 52%, respectively, compared to baseline. Scores persisted below baseline for at least 12 weeks beyond the last IA. The intervention was also well tolerated with no severe adverse events during a total of 35 procedures.Conclusion: Data of this preliminary trial indicates clinical efficacy, feasibility, safety as well as tolerability of IgE-selective IA in AD. K E Y W O R D S atopic dermatitis, IgEnio, immunoadsorption # Damian Meyersburg and Martin Laimer contributed equally to this work.

show abstract

Are Biologics Efficacious in Atopic Dermatitis? A Systematic Review and Meta-Analysis

Abstract: Dupilumab is currently the only biologic with robust evidence of efficacy in AD. Nemolizumab, lebrikizumab, and tralokinumab show promise but further data are needed. Longer follow-up and larger studies will establish their safety profile.

Cited by 66 publications

References 48 publications

First-in-human topical microbiome transplantation with Roseomonas mucosa for atopic dermatitis

First-in-human topical microbiome transplantation with Roseomonas mucosa for atopic dermatitis

Treatment of atopic dermatitis with dupilumab: experience from a tertiary referral centre

Single‐use IgE‐selective immunoadsorber column for the treatment of severe atopic dermatitis

Contact Info

Product

Resources

About