Lieneke F.M. Ariëns, Abhijit Gadkari, Harmieke van Os-Medendorp, Rajeev Ayyagari, Emi Terasawa, Andreas Kuznik, Zhen Chen, Gaëlle Bégo-Le Bagousse, Yufang Lu, Elena Rizova, Neil M.H. Graham, Gianluca Pirozzi, Marjolein De Bruin-Weller, Laurent Eckert
DOI: 10.2340/00015555-3219

Dupilumab is approved for uncontrolled moderate-to-severe atopic dermatitis (AD); cyclosporine is approved for severe AD for ≤ 1 year. The efficacy/effectiveness of these treat­ments was compared indirectly. Regression models used pooled patient-level data to estimate response (Eczema Area and Severity Index (EASI) EASI-50/EASI-75 at weeks 12–16 and 24–30) to dupilumab 300 mg every 2 weeks (CHRONOS [NCT02260986]) or cyclosporine (University Medical Center). Models were adjusted for sex, baseline EASI, and thymus and activation-regulated chemokine level. A total of 106 patients received dupilumab (+ topical cortico­steroids; + TCS), and 57 received cyclosporine (+ TCS). Among University Medical Center patients, estimated EASI-50 responders were, dupilumab vs. cyclosporine, 91% vs. 77% (p = 0.038; weeks 12–16), and 96% vs. 67% (p < 0.0001; weeks 24–30); EASI-75 responders were 78% vs. 56% (p = 0.016; weeks 12–16) and 80% vs. 47% (p <0.001; weeks 24–30). Among CHRONOS patients, estimated EASI-50 responders were 90% vs. 74% (p <0.038; weeks 12–16) and 92% vs. 53% (p < 0.0001; weeks 24–30); EASI-75 responders were 75% vs. 52% (p = 0.016; weeks 12–16) and 74% vs. 40% (p <0.001; weeks 24–30), respectively. These results suggest a higher relative efficacy of dupilumab vs. cyclosporine.

Dupilumab is approved for uncontrolled moderate-to-severe atopic dermatitis; cyclosporine is approved for severe atopic dermatitis. Efficacy/effectiveness were compared indirectly using regression models. Estimated response was evaluated using 50% improvement in Eczema Area and Severity Index (EASI-50) and 75% improvement (EASI-75) at weeks 12–16 and 24–30 to dupilumab (data from CHRONOS study) or cyclosporine (data from University Medical Center; UMC). For UMC patients, EASI-50 responders were, dupilumab vs. cyclosporine, 91% vs. 77% at weeks 12–16, and 96% vs. 67% at weeks 24–30; EASI-75 responders were 78% vs. 56% at weeks 12–16, and 80% vs. 47% at weeks 24–30. For CHRONOS, EASI-50 responders were 90% vs. 74% and 92% vs. 53%; EASI-75 responders were 75% vs. 52% at weeks 12–16, and 74% vs. 40% at weeks 24–30, respectively. These results suggest a higher relative efficacy of dupilumab vs. cyclosporine.