4CPS-166 Reasons and clinical outcomes of switching strategy between dupilumab and tralokinumab in atopic dermatitis in clinical practice
Year: 2025
Type: conference-paper
Study design: Observational Study
Abstract: Background and Importance Dupilumab (D) and tralokinumab (T) are biological agents approved to treat moderate to severe atopic dermatitis (AD). Clinical outcomes of switching strategy between them have not been thoroughly studied in real-world settings. Aim and Objectives To evaluate the reasons and clinical outcomes of switching between D and T. Material and Methods A retrospective study was conducted at a tertiary hospital from 01/2020–07/2024. We included all AD patients who initiated treatment with D or T and switched to the other agent. We collected the following data from medical records: age, sex, reasons for switching and adverse effects (AEs). Results A total of 301 patients initiated a biologic treatment for AD during the study period: dupilumab (n=234), tralokinumab (n=40) and both agents (n=27). Of these 27 patients who received both drugs, the following transitions were observed: D->T (n=15), T->D (n=7), D->T->D (n=4) and T->D->T (n=1). Consequently, there were 20 transitions D->T and 12, T->D (32 cases). The mean age was 48 (±17) years and 51% were male. In the D->T group, 15 switches (75%) were due to AEs and 5 to ineffectiveness. In the T->D group, eight switches (67%) were due to ineffectiveness and four to AEs. Most AE were conjunctivitis and facial erythema. Among patients who switched their treatment for conjunctivitis in the D->T group, 3/9 cases also experienced it with T (in two this led to treatment discontinuation). Similarly, in the T->D group, 1/3 cases also developed it with D but could continue the therapy with close ophthalmologic follow-up. Among the 20 D->T cases, at time of study analysis, nine cases (45%) continued with T whereas five had discontinued for ineffectiveness, three for AE and three were lost to follow-up. On the other hand, among the 12 T->D cases, eight cases (67%) continued with D, whereas two cases had discontinued for AE and two were lost to follow-up. Conclusion and Relevance In our study, the main reason for D->T switching in AD patients was conjunctivitis, whereas for T->D was ineffectiveness. Furthermore, our results suggest that some patients may benefit from a switching strategy between biological agents for AD. References and/or Acknowledgements Conflict of Interest No conflict of interest
Authors: M Panisello Cardona, P Riera, M Masip, A Domínguez Navarro, M Pedemonte i Pons, I Martin Da Silva, JL Spertino, E Serra Baldrich, N Pagès Puigdemont
Institution: Hospital de Sant Pau
Language: English
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4408376289