Adlene Adnan
University of Liverpool, United Kingdom
Title: Use of Biologics in Management of Atopic Eczema
Biography
Biography: Adlene Adnan
Abstract
Introduction:
Atopic dermatitis (AD) is a common inflammatory skin disease distinguished by intense pruritus, and excoriations. Most can be treated with topical agents. Some requires systemic therapy; however they have multiple adverse effects and limited efficacy. Dupilumab is the first targeted biologic agent, recently approved for the treatment of moderate-to-severe AD. It is a fully-human monoclonal antibody and blocks the shared IL-4 receptor which is proposed to be a critical pathway in allergic diseases.
Methods:
A search through Pubmed, Medline, DermNet, BAD Journals, Uptodate, and Embase was performed on use of dupilumab in treating moderate-to-severe AD. The articles found were reviewed and analysed.
Results:
The efficacies of different dupilumab doses were analysed and it showed that patients treated with dupilumab 300 mg weekly had similar clinical outcomes to those receiving 300 mg every alternate week. Therefore, NICE Guidance has recommended a dose of dupilumab every alternate week so as to be cost-effective in the NHS. Its safety profile is considered superior to that of immunosuppressive drugs, as it specifically blocks signals from IL-4 and IL-13 only. Common side effects of dupilumab are conjunctivitis, headaches and cold sores.
Conclusion:
The recommended criteria on indications to initiate Dupilumab treatment for moderateto-severe AD in adults is when the disease has not responded adequately to at least one other systemic therapy, or these are contraindicated or not tolerated. An adequate response is seen if there is at least 50% reduction in the EASI 50 at least a 4-point reduction in the DLQI from initiation of treatment.