1. Successful tapering of dupilumab in patients with atopic dermatitis with low disease activity: a large pragmatic daily practice study from the BioDay registry.
- Author
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Spekhorst, L.S., Boesjes, C.M., Loman, L., Zuithoff, N.P.A., Bakker, D.S., Kamphuis, E., Kamsteeg, M., Haeck, I.M., Oosting, A.J., Lumig, P.P.M. van, Lynden-van Nes, A.M.T. van, Tupker, R.A., Flinterman, A., Garritsen, F.M., Touwslager, W.R.H., Bruin-Weller, M.S. de, Schuttelaar, M.A., Graaf, M de, Spekhorst, L.S., Boesjes, C.M., Loman, L., Zuithoff, N.P.A., Bakker, D.S., Kamphuis, E., Kamsteeg, M., Haeck, I.M., Oosting, A.J., Lumig, P.P.M. van, Lynden-van Nes, A.M.T. van, Tupker, R.A., Flinterman, A., Garritsen, F.M., Touwslager, W.R.H., Bruin-Weller, M.S. de, Schuttelaar, M.A., and Graaf, M de
- Abstract
Contains fulltext : 296145.pdf (Publisher’s version ) (Open Access), BACKGROUND: Limited data are available regarding patient-centred dosing of dupilumab for atopic dermatitis (AD) in daily practice. OBJECTIVES: To evaluate our patient-centred dupilumab dosing regimen in daily practice, to assess prognostic factors for successful tapering and to estimate medication-related cost savings. METHODS: This prospective multicentre study included adult patients with AD, participating in the BioDay registry, treated with dupilumab for ≥ 1.3 years. Interval prolongation was considered in the case of dupilumab standard dose for ≥ 1 year and persistent controlled AD [Eczema Area and Severity Index (EASI) ≤ 7; ≥ 6 months]. Primary endpoints were the mean EASI and Numeric Rating Scale (NRS)-pruritus after the start of tapering. Prognostic factors for successful tapering were analysed with logistic regression and a cost-savings analysis was performed. RESULTS: A total of 595 patients were included, of whom 401 patients [mean EASI 2.5 (SD 2.3); NRS-pruritus of 2.4 (SD 1.9) at the start of tapering] prolonged their dupilumab interval. In 83.3% of these patients tapering was successful; most patients used dupilumab every 3 or 4 weeks (Q3W/Q4W). A significant small increase was observed for EASI (highest mean 3.5) and NRS-pruritus (highest mean 3.2) (P < 0.001); however, scores remained low. Predicting successful tapering showed nonsignificant odds ratios for all incorporated variables. The estimated cost savings was €3 977 033.98 for 401 patients between January 2019 and June 2022. CONCLUSIONS: This study showed successful tapering of dupilumab in 83.3% of patients with AD who attempted tapering, while maintaining controlled disease and with the majority using Q3W/Q4W. Interval prolongation can be beneficial both for the patient and from a socio-economic perspective.
- Published
- 2023