TY - JOUR
T1 - Efficacy and safety of dupilumab for moderate-to-severe atopic dermatitis
T2 - A systematic review for the EAACI biologicals guidelines
AU - Agache, Ioana
AU - Song, Yang
AU - Posso, Margarita
AU - Alonso-Coello, Pablo
AU - Rocha, Claudio
AU - Solà, Ivan
AU - Beltran, Jessica
AU - Akdis, Cezmi
AU - Akdis, Mubeccel
AU - Brockow, Knut
AU - Chivato, Tomas
AU - Del Giacco, Stefano
AU - Eiwegger, Thomas
AU - Eyerich, Kilian
AU - Giménez-Arnau, Ana
AU - Gutermuth, Jan
AU - Guttman-Yassky, Emma
AU - Maurer, Marcus
AU - Ogg, Graham
AU - Ong, Peck Y
AU - O'Mahony, Liam
AU - Schwarze, Jürgen
AU - Werfel, Thomas
AU - Canelo-Aybar, Carlos
AU - Palomares, Oscar
AU - Jutel, Marek
N1 - © 2020 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.
PY - 2021/1
Y1 - 2021/1
N2 - This systematic review evaluates the efficacy, safety and economic impact of dupilumab compared to standard of care for uncontrolled moderate-to-severe atopic dermatitis (AD). Pubmed, EMBASE and Cochrane Library were searched for RCTs and health economic evaluations. Critical and important AD-related outcomes were considered. The risk of bias and the certainty of the evidence were assessed using GRADE. Seven RCTs including 1845 subjects >12 years treated with dupilumab 16 to 52 weeks were evaluated. For adults, there is high certainty that dupilumab decreases SCORAD (MD -30,72; 95% CI -34,65% to -26,79%) and EASI-75 (RR 3.09; 95% CI 2.45 to 3.89), pruritus (RR 2.96; 95% CI 2.37 to 3.70), rescue medication (RR 3.46; 95% CI 2.79 to 4.30), sleep disturbance (MD -7.29; 95% CI -8.23 to -6.35) and anxiety/depression (MD -3.08; 95% CI -4.41 to -1.75) and improves quality of life (MD -4.80; 95% CI -5.55 to -4.06). The efficacy for adolescents is similar. Dupilumab-related adverse events (AEs) slightly increase (low certainty). The evidence for dupilumab-related serious AE is uncertain. The incremental cost-effectiveness ratio ranged from 28 500 £ (low certainty) to 124 541 US$ (moderate certainty). More data on long-term safety are needed both for children and for adults, together with more efficacy data in the paediatric population. Registration: PROSPERO (CRD42020153645).
AB - This systematic review evaluates the efficacy, safety and economic impact of dupilumab compared to standard of care for uncontrolled moderate-to-severe atopic dermatitis (AD). Pubmed, EMBASE and Cochrane Library were searched for RCTs and health economic evaluations. Critical and important AD-related outcomes were considered. The risk of bias and the certainty of the evidence were assessed using GRADE. Seven RCTs including 1845 subjects >12 years treated with dupilumab 16 to 52 weeks were evaluated. For adults, there is high certainty that dupilumab decreases SCORAD (MD -30,72; 95% CI -34,65% to -26,79%) and EASI-75 (RR 3.09; 95% CI 2.45 to 3.89), pruritus (RR 2.96; 95% CI 2.37 to 3.70), rescue medication (RR 3.46; 95% CI 2.79 to 4.30), sleep disturbance (MD -7.29; 95% CI -8.23 to -6.35) and anxiety/depression (MD -3.08; 95% CI -4.41 to -1.75) and improves quality of life (MD -4.80; 95% CI -5.55 to -4.06). The efficacy for adolescents is similar. Dupilumab-related adverse events (AEs) slightly increase (low certainty). The evidence for dupilumab-related serious AE is uncertain. The incremental cost-effectiveness ratio ranged from 28 500 £ (low certainty) to 124 541 US$ (moderate certainty). More data on long-term safety are needed both for children and for adults, together with more efficacy data in the paediatric population. Registration: PROSPERO (CRD42020153645).
KW - EASI
KW - SCORAD
KW - atopic dermatitis
KW - cost-effectiveness
KW - dupilumab
UR - http://www.scopus.com/inward/record.url?scp=85092080865&partnerID=8YFLogxK
U2 - 10.1111/all.14510
DO - 10.1111/all.14510
M3 - Article
C2 - 32691892
VL - 76
SP - 45
EP - 58
JO - Allergy
JF - Allergy
SN - 0105-4538
IS - 1
ER -