loading page

Efficacy and safety of dupilumab for moderate-to-severe atopic dermatitis: a systematic review for the EAACI Biologicals Guidelines
  • +23
  • Ioana Agache,
  • Yang Song,
  • Margarita Posso,
  • Pablo Alonso-Coello,
  • Claudio Rocha,
  • Ivan Sola,
  • Jessica Beltran,
  • Cezmi Akdis,
  • Mubeccel Akdis,
  • Knut Brockow,
  • T. Chivato,
  • Stefano R. Del Giacco,
  • Thomas Eiwegger,
  • Kilian Eyerich,
  • Ana Giménez Arnau,
  • Jan Gutermuth,
  • Emma Guttmann-Yassky,
  • Marcus Maurer,
  • Graham Ogg,
  • Peck Ong,
  • Liam O'Mahony,
  • Jürgen Schwarze,
  • Thomas Werfel,
  • Carlos Canelo-Aybar,
  • Oscar Palomares,
  • Marek Jutel
Ioana Agache
Transylvania University of Brasov

Corresponding Author:[email protected]

Author Profile
Yang Song
Biomedical Research Institute Sant Pau
Author Profile
Margarita Posso
IMIM
Author Profile
Pablo Alonso-Coello
Hospital Sant Pau
Author Profile
Claudio Rocha
Biomedical Research Institute Sant Pau
Author Profile
Ivan Sola
Biomedical Research Institute
Author Profile
Jessica Beltran
Biomedical Research Institute Sant Pau
Author Profile
Cezmi Akdis
University of Zurich
Author Profile
Mubeccel Akdis
University of Zürich
Author Profile
Knut Brockow
Technical University of Munich
Author Profile
T. Chivato
Univ CEU San Pablo
Author Profile
Stefano R. Del Giacco
University of Cagliari Faculty of Medicine
Author Profile
Thomas Eiwegger
The Hospital for Sick Children
Author Profile
Kilian Eyerich
TUM
Author Profile
Ana Giménez Arnau
Hospital del Mar. Institut Mar d´Investigacions Mediques
Author Profile
Jan Gutermuth
Universitair Ziekenhuis Brussel
Author Profile
Emma Guttmann-Yassky
Rockefeller University
Author Profile
Marcus Maurer
Charité Universitätsmedizin Berlin
Author Profile
Graham Ogg
University of Oxford
Author Profile
Peck Ong
Childrens Hospital Los Angeles, University of Southern California Keck School of Medicine
Author Profile
Liam O'Mahony
University College Cork National University of Ireland
Author Profile
Jürgen Schwarze
University of Edinburgh, Edinburgh
Author Profile
Thomas Werfel
Hannover Medical School
Author Profile
Carlos Canelo-Aybar
Biomedical Research Institute Sant Pau
Author Profile
Oscar Palomares
Complutense University of Madrid
Author Profile
Marek Jutel
Wroclaw Medical University
Author Profile

Abstract

This systematic review evaluates the efficacy, safety and economic impact of dupilumabcompared to standard of care for uncontrolled moderate-to-severe atopic dermatitis (AD). Pubmed, EMBASE and Cochrane Library were searched for RCTs and health economic evaluations. Critical and important AD-related outcomes were considered. The risk of bias and the certainty of the evidence were assessed using GRADE. Seven RCTs including 1845 subjects > 12 years treated with dupilumab16 to 52 weeks were evaluated. For adultsthere is high certainty that dupilumabdecreasesSCORAD (MD -30,72; 95%CI -34,65% to -26,79%) and EASI-75 (RR 3.09; 95%CI 2.45 to 3.89), pruritus (RR 2.96; 95%CI 2.37 to 3.70), rescue medication (RR 3.46; 95%CI 2.79 to 4.30), sleep disturbance (MD -7.29; 95%CI -8.23 to -6.35), anxiety/depression (MD -3.08; 95% CI -4.41 to -1.75) and improves quality of life (MD -4.80; 95% CI -5.55 to -4.06). The efficacy for adolescents is similar. Dupilumab-related adverse events (AEs) slightly increase (low certainty). The evidence for dupilumab-related serious AE is uncertain. The incremental cost-effectiveness ratio ranged from 28,500 £ (low certainty) to 124,541 US$ (moderate certainty).More data on long term safety are needed both for children and adults, together with more efficacy data in the paediatric population.
08 Jul 2020Submitted to Allergy
08 Jul 2020Assigned to Editor
08 Jul 2020Submission Checks Completed
08 Jul 2020Reviewer(s) Assigned
13 Jul 2020Review(s) Completed, Editorial Evaluation Pending
14 Jul 2020Editorial Decision: Accept
Jan 2021Published in Allergy volume 76 issue 1 on pages 45-58. 10.1111/all.14510