Black/African American Patients With Atopic Dermatitis Report Improvements, Satisfaction on Dupixent

Among Black/African American adults with moderate to severe atopic dermatitis (AD), the use of Dupixent (dupilumab) reduced concomitant AD medication use and improved disease control, sleep problems and skin symptoms with sustained patient satisfaction in the real world, according to posters presented at the Fall Clinical Dermatology meeting.

Atopic dermatitis

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Dupixent is a monoclonal antibody targeting interleukin-4, which is responsible for the type 2 inflammation that causes the symptoms of AD. The therapy is approved to treat patients aged 6 months and older with moderate to severe AD that has been inadequately controlled by topical therapies.

The posters reported on a subgroup analysis of the Black/African American population in RELIEVE-AD, a prospective, real-world longitudinal patient survey study. According to the researchers, this is a population with limited clinical study data.

A total of 64 Black/African American patients completed the baseline survey with 43 providing responses at Month 12. Of those who completed the survey, the majority were female (86%) and the mean age was 38.8 years. In addition, 27% of patients reported experiencing type 2 comorbid diseases.

At baseline, only 7.8% of patients reported no concomitant treatment use, which increased significantly by Month 12 to 30.2%. The proportion of patients on 3 or more concomitant treatments decreased from 9.4% at baseline to 4.7%; the proportion on 2 concomitant treatments decreased from 29.7% to 20.9%; and the proportion on 1 concomitant treatment dropped from 53.1% to 44.2%.

Prescription topical medication use decreased from 87.5% to 67.4% and use of systemic steroids and immunosuppressants was reduced from 32.8% to 14%.

From baseline, the mean total AD Control Tool (ADCT) decreased significantly from 16.8 at baseline to 7.3 at Month 1 and 4.9 at Month 12. Based on the ADCT score, a total score of less than 7 indicates disease control. The proportion of patients with controlled disease was only 1.6% at baseline, which increased to 72.1% at Month 12.

Patients also reported improvements in sleep problems and skin symptoms. At baseline, 73.4% of patients reported AD-related sleep problems, which decreased significantly to 29.4% at Month 1 and further to 18.6% at Month 12. Sleep was assessed using a simple question with a yes or no answer.

Skin symptoms were assessed using a numerical rating scale with 0 meaning no symptoms and 10 being the worst symptom severity. At baseline the scores were 6.2 for skin pain, 5.0 for skin feeling hot/burning and 5.8 for skin sensitivity. By Month 12 the scores were 1.9 for skin pain, 1.4 for skin feeling hot/burning and 1.6 for skin sensitivity.

In addition, health-related quality of live was evaluated using the Dermatology Life Quality Index (DLQI), which indicates the negative effect of their disease. The mean DLQI score was 16.6 at baseline, which corresponded to a very large effect, and improved significantly to 6.8 at Month 1, corresponding to a moderate effect, and 4.6 at Month 12, corresponding to a small effect. At Month 12, 34.9% reported their AD had no effect on their lives.

At baseline, 28.1% of patients reported being extremely, very, or somewhat satisfied with their current treatment (s), which increased significantly by Month 12 following initiation of Dupixent to 83.7%.

The researchers did note that the small sample size of the subgroup and the attrition over the study period should be taken into account when interpreting the results of the analysis.