Real-world evaluation of the effectiveness and safety of dupilumab in bullous pemphigoid: an ambispective multicentre case series
Year: 2024
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Bullous pemphigoid (BP) affects elderly individuals with multiple comorbidities, making conventional treatments unsuitable. OBJECTIVES: Evaluate the effectiveness and safety of dupilumab in the treatment of BP. METHODS: A multicentre ambispective cohort study was conducted across 34 hospitals. Patients with BP treated with dupilumab were included. Most of the patients (97.1%) received an initial 600-mg dose followed by 300 mg every 2 weeks. The primary outcome was the proportion of patients achieving complete remission (CR) within 4 weeks, defined as an Investigator's Global Assessment score of 0 or 1. CR at weeks 16, 24 and 52, adverse events (AEs), reductions in Peak Pruritus Numerical Rating Scale (PP-NRS) and systemic glucocorticoid use were also assessed. RESULTS: The study included 103 patients with a median age of 77.3 years; 58.3% were male. CR was achieved by 53.4% within 4 weeks and 95.7% by week 52. The PP-NRS score reduced by 70.0% by week 4 and was completely controlled by week 24. Thirteen patients presented with AEs, most of which were mild. Systemic glucocorticoid use reduced by 82.1% by week 52. Shorter disease duration and exclusive cutaneous involvement predicted better response at 16 weeks. No differences in response rates to dupilumab were observed between drug-associated BP and idiopathic cases. No significant difference in response rates was observed between patients treated with dupilumab in monotherapy and those receiving dupilumab with concomitant treatments. CONCLUSIONS: Dupilumab is effective, rapid and safe in managing BP, reducing the need for corticosteroids and other treatments. Early initiation and exclusive skin involvement predict better outcomes.
Source: British Journal of Dermatology
DOI: 10.1093/bjd/ljae403
Authors: Nidia Planella-Fontanillas, Xavier Bosch-Amate, Alicia Jiménez Antón, Carlos Moreno-Vílchez, María Gamo Guerrero, María del Mar Blanes Martínez, María Asunción Ballester Martínez, Patricia Bassas-Freixas, Juan Luis Castaño Fernández, Andrea Estébanez Corrales, Ricardo Suarez Fernández, Sergio Santos Alarcón, Ana Bauzá Alonso, Marina Torrent, Adrian Ballano Ruiz, Cristina Collantes Rodríguez, Agustín España, Eduardo Fonseca Capdevila, Inmaculada Gil Faure, Carlos Pelayo Hernández Fernández, Francisco Javier Melgosa Ramos, Jorge Spertino, Violeta Zaragoza Ninet, Lucia Armillas, Isabel Bielsa, Cristina Carrera, Mireia Esquius Rafat, Jon Fulgencio Barbarin, Javier Fernandez Vela, Miguel Lova Navarro, Clara Martín Callizo, Sara Martín-Sala, Rosa Ojeda, Maria Elisabet Parera Amer, Anna Sánchez Puigdollers, Ramon M Pujol, Sebastian Podlipnik, José Manuel Mascaró, Laia Curto-Barredo
Institutions: Universitat Pompeu Fabra, Hospital del Mar Research Institute, Hospital Clínic de Barcelona, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Universitat de Barcelona, Hospital Universitario Puerta del Mar, Bellvitge University Hospital, Hospital Universitario Infanta Leonor, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Universidad de Alcalá, Hospital Universitario Ramón y Cajal, Vall d'Hebron Hospital Universitari, Hospital Universitario Puerta de Hierro Majadahonda, Hospital Universitario Doctor Peset, Hospital General Universitario Gregorio Marañón, Hospital Virgen de los Lirios, Hospital Universitario Son Espases, Hospital General Universitario Santa María del Rosell, Hospital Universitario del Henares, Hospital Regional Universitario de Málaga, Clinica Universidad de Navarra, Complexo Hospitalario Universitario A Coruña, Hospital Universitari Sant Joan de Reus, Hospital Universitario de Gran Canaria Doctor Negrín, Hospital Universitario Lluís Alcanyís, Hospital de Sant Pau, Hospital General Universitario De Valencia, Hospital Comarcal de Inca, Hospital Universitari Germans Trias i Pujol, Althaia, Hospital Universitario 12 De Octubre, Hospital General de Granollers, Hospital Universitario Virgen de la Arrixaca, Hospital Universitari Joan XXIII de Tarragona, Hospital Son Llatzer, Hospital Universitari Sagrat Cor
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4403483934