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• W4200068111 abstract "DermatitisVol. 33, No. 3 LettersFree AccessPatients Withdrawing Dupilumab Monotherapy for COVID-19–Related Reasons Showed Similar Disease Course Compared With Patients Continuing Dupilumab TherapyAndrea Chiricozzi, Lucia Di Nardo, Marina Talamonti, Marco Galluzzo, Clara De Simone, Gabriella Fabbrocini, Angelo Valerio Marzano, Giampiero Girolomoni, Annamaria Offidani, Maria Teresa Rossi, Luca Bianchi, Antonio Cristaudo, Maria Teresa Fierro, Luca Stingeni, Giovanni Pellacani, Giuseppe Argenziano, Annalisa Patrizi, Paolo Pigatto, Marco Romanelli, Paola Savoia, Pietro Rubegni, Caterina Foti, Nicola Milanesi, Anna Belloni Fortina, Maria Rita Bongiorno, Teresa Grieco, Sergio Di Nuzzo, Maria Concetta Fargnoli, Andrea Carugno, Alberico Motolese, Franco Rongioletti, Paolo Amerio, Riccardo Balestri, Concetta Potenza, Giuseppe Micali, Cataldo Patruno, Iris Zalaudek, Maurizio Lombardo, Claudio Feliciani, Flaminia Antonelli, Silvia Mariel Ferrucci, Fabrizio Guarneri, and Ketty PerisAndrea ChiricozziDermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, ItalySearch for more papers by this author, Lucia Di NardoDermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy Search for more papers by this authorEmail the corresponding author at [email protected], Marina TalamontiDermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, ItalySearch for more papers by this author, Marco GalluzzoDermatology Unit, Policlinico Tor Vergata, Department of Systems Medicine, Tor Vergata University of Rome, ItalySearch for more papers by this author, Clara De SimoneDermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, ItalySearch for more papers by this author, Gabriella FabbrociniDermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, ItalySearch for more papers by this author, Angelo Valerio MarzanoSection of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, ItalySearch for more papers by this author, Giampiero GirolomoniDermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, ItalySearch for more papers by this author, Annamaria OffidaniDepartment of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, ItalySearch for more papers by this author, Maria Teresa RossiSection of Dermatology and Venereology, Department of Medicine, University of Verona, ItalySearch for more papers by this author, Luca BianchiDermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, ItalySearch for more papers by this author, Antonio CristaudoDepartment of Dermatology, ASST Spedali Civili of Brescia, University of Brescia, ItalySearch for more papers by this author, Maria Teresa FierroDermatology Unit, Policlinico Tor Vergata, Department of Systems Medicine, Tor Vergata University of Rome, ItalySearch for more papers by this author, Luca StingeniClinical Dermatology, San Gallicano Dermatological Institute, Rome, ItalySearch for more papers by this author, Giovanni PellacaniMedical Sciences Department, Dermatologic Clinic, University of Turin, ItalySearch for more papers by this author, Giuseppe ArgenzianoDermatology Section, Department of Medicine, University of Perugia, ItalySearch for more papers by this author, Annalisa PatriziUnit of Dermatology, Department of Clinical Internal, Anesthesiological, and Cardiovascular Sciences, Sapienza University of Rome, ItalySearch for more papers by this author, Paolo PigattoDermatology Unit, University of Campania Luigi Vanvitelli, Naples, ItalySearch for more papers by this author, Marco RomanelliDermatology UOC, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, ItalySearch for more papers by this author, Paola SavoiaDepartment of Biomedical, Surgical and Dental Sciences, Clinical Dermatology, IRCCS Galeazzi Orthopaedic Institute, University of Milan, ItalySearch for more papers by this author, Pietro RubegniDepartment of Dermatology, University of Pisa, ItalySearch for more papers by this author, Caterina FotiDepartment of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this author, Nicola MilanesiDermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, ItalySearch for more papers by this author, Anna Belloni FortinaDepartment of Biomedical Science and Human Oncology, Unit of Dermatology, University of Bari, ItalySearch for more papers by this author, Maria Rita BongiornoDermatology Clinic, Department of Health Sciences, University of Florence, ItalySearch for more papers by this author, Teresa GriecoDermatology Unit, Department of Medicine DIMED, University of Padova, ItalySearch for more papers by this author, Sergio Di NuzzoSection of Dermatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, ItalySearch for more papers by this author, Maria Concetta FargnoliUnit of Dermatology, Department of Clinical Internal, Anesthesiological, and Cardiovascular Sciences, Sapienza University of Rome, ItalySearch for more papers by this author, Andrea CarugnoDepartment of Medicine and Surgery, University of Parma, ItalySearch for more papers by this author, Alberico MotoleseDermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, ItalySearch for more papers by this author, Franco RongiolettiDermatology Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, ItalySearch for more papers by this author, Paolo AmerioDermatology Unit, Department of Medical Specialties, Arcispedale Santa Maria Nuova-IRCCS di Reggio Emilia, ItalySearch for more papers by this author, Riccardo BalestriVita-Salute San Raffaele University and IRCCS San Raffaele Hospital, Milan, ItalySearch for more papers by this author, Concetta PotenzaUnit of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, ItalySearch for more papers by this author, Giuseppe MicaliDepartment of Medicine and Aging Science, Dermatologic Clinic, G. D'Annunzio University, Chieti, ItalySearch for more papers by this author, Cataldo PatrunoDivision of Dermatology, Santa Chiara Hospital, Trento, ItalySearch for more papers by this author, Iris ZalaudekDepartment of Medico-Surgical Sciences and Biotechnologies, Dermatology Unit 'Daniele Innocenzi' Sapienza University of Rome–Polo Pontino, ItalySearch for more papers by this author, Maurizio LombardoDermatology Clinic, University of Catania, ItalySearch for more papers by this author, Claudio FelicianiDermatology Unit, Department of Health Sciences, Università Magna Graecia, Catanzaro, ItalySearch for more papers by this author, Flaminia AntonelliDepartment of Dermatology, University of Trieste, ItalySearch for more papers by this author, Silvia Mariel FerrucciUnit of Dermatological Diseases, ASST Sette Laghi, Ospedale di Circolo, Varese, ItalySearch for more papers by this author, Fabrizio GuarneriSection of Dermatology, Department of Medicine and Surgery, University of Parma, ItalySearch for more papers by this author, and Ketty PerisDermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, ItalySearch for more papers by this authorPublished Online:1 Jun 2022AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail To the Editor:Atopic dermatitis (AD) is a chronic inflammatory skin disease that is treated with phototherapy or systemic therapies when the disease is assessed as moderate-severe and unresponsive to topical therapies.During COVID-19 pandemic, a few studies described the therapeutic management of AD.1–3 In Italy, the DA-COVID-19 national registry was created to collect clinical data about the management of moderate-severe AD patients during the lockdown period (starting from February to June 2020). Pandemic-related sanitary restrictions limited the access to hospitals and determined the implementation of regular visits with telemedicine, resulting in a predominant patient-oriented assessment of disease severity.3 Three time points for data collection were considered.3Herein,3 we describe AD course after dupilumab withdrawal. The effectiveness of dupilumab in the treatment of moderate-severe AD has been widely characterized in both real-world and clinical trial settings.4,5 However, there is no evidence about the maintenance of treatment response after withdrawal of dupilumab therapy.Of 1013 patients treated with dupilumab monotherapy, 75 (7.4%) interrupted therapy, with a mean duration of treatment withdrawal of 106.4 days (±75.83 days). Significant differences between the subgroup of patients continuing and patients withdrawing therapy throughout the study period were detected, highlighting a lower degree of disease severity in patients continuing therapy (data not shown). In particular, patient self-reported AD severity status showed significantly higher scores in patients withdrawing treatment, independent of the cause of interruption, at any time point (Table 1). Thirty-six of 75 patients withdrew therapy because of the risk factors related to COVID-19 disease (age >65 years, metabolic and/or cardiovascular comorbidities), SARS-CoV-2 infection, fear of increased susceptibility to SARS-CoV-2 infection, or close contact with SARS-CoV-2+ subjects.TABLE 1 AD Course in Patients Withdrawing Dupilumab Monotherapy Because of Reasons Related or Unrelated to SARS-CoV-2 InfectionChanges in mean scores for Eczema Area and Severity Index (EASI), Itch–Numeric Rating Scale (Itch-NRS), and Sleep–Numeric Rating Scale (Sleep-NRS) from time point 3 and time point 1 were not significantly different in the subcohort of patients withdrawing because of SARS-CoV-2–related reasons versus patients continuing dupilumab therapy (Table 1). In this subcohort of patients, mean dupilumab withdrawal period resulted longer intervals (123.2 ± 11.69 days) compared with patients discontinuing dupilumab because of reasons unrelated to SARS-CoV-2 infection (90.03 ± 12.91 days), although this difference was not statistically significant (P = 0.0615).Of 75 patients, 39 patients withdrew dupilumab therapy because of reasons unrelated to COVID-19 disease, including ineffectiveness, adverse events, patient's decision, and issues with drug supply. In contrast to patients withdrawing therapy because of SARS-CoV-2–related reasons, these patients experienced a significant worsening of AD with greater changes in mean EASI score, Itch-NRS, and Sleep-NRS at time point 3 versus time point 1, compared with patients continuing therapy (Table 1). Thus, this study provides relevant insights for physicians about the management of AD patients after dupilumab suspension or withdrawal during COVID-19 pandemic, because a 16-week interruption due to SARS-CoV-2–related reasons did not cause a significant relapse or worsening of the disease.REFERENCES1. Stingeni L, Hansel K, Antonelli E, et al. Atopic dermatitis in adolescents: effectiveness and safety of dupilumab in a 16-week real-life experience during the COVID-19 pandemic in Italy. Dermatol Ther. 2021;34:e15035. . Epub ahead of print. Crossref, Medline, Google Scholar2. Rossi M, Rovati C, Arisi M, et al. Management of adult patients with severe atopic dermatitis treated with dupilumab during COVID-19 pandemic: a single-center real-life experience. Dermatol Ther 2020;33(4):e13765. Crossref, Medline, Google Scholar3. Chiricozzi A, Talamonti M, De Simone C, et al.DA-COVID-19 study group. Management of patients with atopic dermatitis undergoing systemic therapy during COVID-19 pandemic in Italy: data from the DA-COVID-19 registry. Allergy 2021;76(6):1813–1824. Crossref, Medline, Google Scholar4. Gori N, Chiricozzi A, Malvaso D, et al. Successful combination of systemic agents for the treatment of atopic dermatitis resistant to dupilumab therapy. Dermatology 2021;237(4):535–541. Crossref, Medline, Google Scholar5. Deleuran M, Thaçi D, Beck LA, et al. Dupilumab shows long-term safety and efficacy in patients with moderate to severe atopic dermatitis enrolled in a phase 3 open-label extension study. J Am Acad Dermatol 2020;82(2):377–388. Crossref, Medline, Google ScholarFiguresReferencesRelatedDetails Volume 33Issue 3Jun 2022 Information© 2021 American Contact Dermatitis Society. All Rights Reserved.To cite this article:Andrea Chiricozzi, Lucia Di Nardo, Marina Talamonti, Marco Galluzzo, Clara De Simone, Gabriella Fabbrocini, Angelo Valerio Marzano, Giampiero Girolomoni, Annamaria Offidani, Maria Teresa Rossi, Luca Bianchi, Antonio Cristaudo, Maria Teresa Fierro, Luca Stingeni, Giovanni Pellacani, Giuseppe Argenziano, Annalisa Patrizi, Paolo Pigatto, Marco Romanelli, Paola Savoia, Pietro Rubegni, Caterina Foti, Nicola Milanesi, Anna Belloni Fortina, Maria Rita Bongiorno, Teresa Grieco, Sergio Di Nuzzo, Maria Concetta Fargnoli, Andrea Carugno, Alberico Motolese, Franco Rongioletti, Paolo Amerio, Riccardo Balestri, Concetta Potenza, Giuseppe Micali, Cataldo Patruno, Iris Zalaudek, Maurizio Lombardo, Claudio Feliciani, Flaminia Antonelli, Silvia Mariel Ferrucci, Fabrizio Guarneri, and Ketty Peris.Patients Withdrawing Dupilumab Monotherapy for COVID-19–Related Reasons Showed Similar Disease Course Compared With Patients Continuing Dupilumab Therapy.Dermatitis.Jun 2022.e25-e29.http://doi.org/10.1097/DER.0000000000000814Published in Volume: 33 Issue 3: June 1, 2022PDF download" @default.
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• W4200068111 title "Patients Withdrawing Dupilumab Monotherapy for COVID-19–Related Reasons Showed Similar Disease Course Compared With Patients Continuing Dupilumab Therapy" @default.
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