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Vol. 109. Num. 3.April 2018
Pages e13-e22Pages 197-292
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Vol. 109. Num. 3.April 2018
Pages e13-e22Pages 197-292
Novelties in Dermatology
DOI: 10.1016/j.adengl.2018.02.019
Dupilumab for the Treatment of Atopic Dermatitis
Dupilumab para el tratamiento de la dermatitis atópica
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S. Ferreiraa, T. Torresa,b,
Corresponding author
torres.tiago@outlook.com

Corresponding author.
a Department of Dermatology, Centro Hospitalar Universitário do Porto, Oporto, Portugal
b Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Oporto, Portugal
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Table 1. Efficacy outcomes in Phase IIb and III (SOLO 1 and 2) studies of dupilumab in atopic dermatitis at week 16.
Table 2. Efficacy outcomes in Phase III Study of dupilumab in atopic dermatitis – LIBERTY AD CHRONOS – at week 16 and 52.
Table 3. Adverse events in Phase I (M4A and M4B) and IIa (M12 and C4) studies of dupilumab in atopic dermatitis*
Table 4. Adverse events in Phase IIb and III (SOLO 1 and 2, and LIBERTY AD CHRONOS) studies of dupilumab in atopic dermatitis*
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Abstract

Atopic dermatitis (AD) is a common, chronic, inflammatory skin disorder with high physical and emotional burden. AD usually starts in early childhood and has a heterogeneous course. Emerging evidence suggests that IL-4 and IL-13 are key cytokines in the immunopathogenesis of AD. Dupilumab is a monoclonal antibody directed against IL-4 receptor α subunit, that blocks both IL-4 and IL-13 signaling. Data from Phase I-III studies revealed that dupilumab, administered as monotherapy or with topical corticosteroids, is effective and well tolerated in the treatment of adult patients with moderate-to-severe AD. A large proportion of patients receiving dupilumab had significant improvements in multiple efficacy indexes, including Eczema Area and Severity Index, Investigator's Global Assessment and SCORing Atopic Dermatitis scores. These results introduce a new era of targeted therapies in the management of AD.

Keywords:
Dupilumab
Atopic dermatitis
Atopic eczema
Interleukin-4
Interleukin-13
Biologic therapy
Resumen

La dermatitis atópica (DA) es una frecuente enfermedad crónica e inflamatoria de la piel que acarrea una fuerte carga física y emocional. La DA suele comenzar a edades tempranas y tiene un curso heterogéneo. Las últimas evidencias a este respecto sugieren que las interleucinas IL-4 e IL-3 son citoquinas claves en la inmunopatogénesis de la DA. El dupilumab es un anticuerpo monoclonal dirigido contra la subunidad del receptor alfa de la IL-4 que bloquea la señalización tanto de la IL-4 como de la IL-3. Datos extraídos de estudios fase i-iii revelan que administrado como monotratamiento o acompañado de corticosteroides tópicos, el dupilumab se tolera bien y resulta efectivo en el tratamiento de pacientes adultos con DA de carácter entre moderado y grave. Un gran número de pacientes que recibieron dupilumab experimentaron mejorías notables en varios índices de eficacia, incluidos el Índice de gravedad y área de eccema, la Escala de evaluación global del investigador y la Escala de dermatitis atópica. Estos resultados abren una nueva era a tratamientos dirigidos en el manejo de la DA.

Palabras clave:
Dupilumab
Dermatitis atópica
Eccema atópico
Interleucina-4
Interleucina-13
Terapia biológica

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