Predisposition to conjunctivitis and male sex reduces drug survival of dupilumab in adults and adolescents

ABSTRACT

Background

There are currently limited data on dupilumab drug survival (DS), especially on factors possibly associated with drug discontinuation.

Materials and methods

The primary endpoint of this study is to evaluate the parameters that may determine drug discontinuation and the predictive factors associated with dupilumab DS. We considered as independent associated factors: childhood onset of disease, gender, age of onset of AD, age of initiation of dupilumab, previous use of cyclosporine, initial mean EASI, atopic family history, and predisposition to allergic conjunctivitis.

Results

On 413 patients DS was 94.5% at 1 year, 89.5% at 2 years, and 83.7% at 3 years, and after a mean follow-up of 40.5 months (±1.6) 53 patients had discontinued the drug permanently (12.8%). Univariate analysis showed that the only factor associated with a reduction in drug survival was a predisposition to allergic conjunctivitis (p 0.009). At multivariate Cox regression, male sex (HR, 2.34; 95% CI, 1.14–4.78; p 0.02) and predisposition to allergic conjunctivitis (HR, 2.61; 95% CI, 1.37–5.00; p 0.004) were associated with lower DS of dupilumab.

Conclusion

Male gender and predisposition to allergic conjunctivitis are negative predictors for maintenance of response to treatment with dupilumab and consequently associated with lower DS rates.

KEYWORDS:

• Dupilumab
• drug survival
• atopic dermatitis
• conjunctivitis
• male sex

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

L Mastorino, and S Ribero were involved in the conception, study design, execution, acquisition of data, analysis, interpretation, reviewing, and drafting the work. I Richiardi was involved in the study design, execution, acquisition of data, analysis, interpretation, reviewing, and drafting the work. F Gelato and G Cavaliere were involved in execution, acquisition of data, analysis, interpretation, and reviewing. M Ortoncelli was involved in the conception, execution, acquisition of data, analysis, interpretation, and reviewing of the study. Pietro Quaglino was involved in the analysis, interpretation, and reviewing of the study. All authors read and approved the present manuscript.

Ethics statement

All patients signed informed consent according to the Declaration of Helsinki agreements and the work was approved within the SS-Dermo-13 protocol by our local ethics committee (CET Interaziendale AOU Città della Salute e della Scienza di Torino). The patient records repository is owned by and used with permission from the University of Turin.

Acknowledgments

The present work was presented by the corresponding author at the 97° SIDeMaST congress, Napoli 2023, as free communication.

Additional information

Funding

This paper was not funded.