High loading-dose of dupilumab resulted in rapid disease control in pediatric patients with atopic dermatitis

作者全名："Wang, Ao; Zhou, Yuan; Luo, Yang; Gao, Yingxia; Chen, Jingsi; Li, Wei; Luo, Xiaoyan; Yao, Xu"

作者地址："[Wang, Ao; Zhou, Yuan; Luo, Yang; Gao, Yingxia; Yao, Xu] Chinese Acad Med Sci & Peking Union Med Coll, Hosp Skin Dis, Inst Dermatol, Dept Allergy & Rheumatol,Jiangsu Key Lab Mol Biol, Nanjing, Peoples R China; [Chen, Jingsi; Luo, Xiaoyan] Chongqing Med Univ, Dept Dermatol, Childrens Hosp, Chongqing, Peoples R China; [Chen, Jingsi; Luo, Xiaoyan] Natl Clin Res Ctr Child Hlth & Disorders, Minist Educ, Key Lab Child Dev & Disorders, Chongqing, Peoples R China; [Li, Wei] Fudan Univ, Huashan Hosp, Dept Dermatol, Shanghai, Peoples R China"

通信作者："Yao, X (通讯作者)，Chinese Acad Med Sci & Peking Union Med Coll, Hosp Skin Dis, Inst Dermatol, Dept Allergy & Rheumatol,Jiangsu Key Lab Mol Biol, Nanjing, Peoples R China.; Luo, XY (通讯作者)，Chongqing Med Univ, Dept Dermatol, Childrens Hosp, Chongqing, Peoples R China.; Luo, XY (通讯作者)，Natl Clin Res Ctr Child Hlth & Disorders, Minist Educ, Key Lab Child Dev & Disorders, Chongqing, Peoples R China.; Li, W (通讯作者)，Fudan Univ, Huashan Hosp, Dept Dermatol, Shanghai, Peoples R China."

来源：FRONTIERS IN IMMUNOLOGY

ESI学科分类：IMMUNOLOGY

WOS号：WOS:000979933000001

JCR分区：Q1

影响因子：7.3

年份：2023

卷号：14

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：atopic dermatitis; CCL17; TARC; children; dupilumab; obesity

摘要："BackgroundThe real-world experience of dupilumab in Chinese is limited, and the initial loading dose has not yet been deeply explored in patients aged ObjectiveTo explore the efficacy and safety of dupilumab in Chinese patients with moderate-to-severe atopic dermatitis and investigate the effect of higher loading dose for disease control in patients aged MethodsA total of 155 patients were divided into three groups according to age: <6 years, 6-11 years, and >11 years. Among patients aged <6 years, 37 patients received a high loading dose of 300 mg for body weight <15kg or 600 mg for body weight >= 15kg, and another 37 patients received a standard loading dose of 200 mg for body weight <15kg or 300 mg for body weight >= 15kg. Multiple physicians and patient-reported outcome measures were evaluated at baseline and 2, 4, 6, 8, 12, and 16 weeks after dupilumab treatment. ResultsThe proportion of patients showing an improvement of >= 75% in the Eczema Area and Severity Index was 68.0% (17/25), 76.9% (10/13), and 62.5% (25/40) in the aged <6, 6-11, and >11 years groups, respectively, at week 16. After increasing the loading dose, 69.6% (16/23) of patients aged <6 years achieved 4-point improvement in Pruritus Numerical Rating Scale at week 2, compared with 23.5% (8/34) of patients receiving standard loading dose (P < 0.001). Obesity (odds ratio=0.12, 95% confidence interval: 0.02-0.70) was predictive of a poor response to dupilumab treatment, while female (odds ratio=3.94, 95% confidence interval: 1.26-12.31) predicted good response at week 16. The change of serum C-C motif ligand 17(CCL17/TARC) could reflect the response to dupilumab (r = 0.53, P = 0.002 in EASI) among patients aged ConclusionsDupilumab was effective and well-tolerated in Chinese patients with atopic dermatitis. The increased loading dose helped achieve rapid pruritus control in patients aged <6 years."

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