Factors Associated with Dupilumab Response in Atopic Dermatitis: A Systematic Review and Meta-Analysis
Issued Date
2024-01-01
Resource Type
ISSN
22132198
Scopus ID
2-s2.0-85205668028
Pubmed ID
39265658
Journal Title
Journal of Allergy and Clinical Immunology: In Practice
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SCOPUS
Bibliographic Citation
Journal of Allergy and Clinical Immunology: In Practice (2024)
Suggested Citation
Chokevittaya P., Jirattikanwong N., Thongngarm T., Phinyo P., Wongsa C. Factors Associated with Dupilumab Response in Atopic Dermatitis: A Systematic Review and Meta-Analysis. Journal of Allergy and Clinical Immunology: In Practice (2024). doi:10.1016/j.jaip.2024.08.054 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/101592
Title
Factors Associated with Dupilumab Response in Atopic Dermatitis: A Systematic Review and Meta-Analysis
Author's Affiliation
Corresponding Author(s)
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Abstract
Background: Dupilumab was approved for treating moderate to severe atopic dermatitis (AD). However, a notable subset of patients remains unresponsive and factors associated with dupilumab response remain limited. Objective: To review and establish factors related to dupilumab response systematically in AD. Methods: We searched electronic databases, including PubMed and MEDLINE, Embase, Ovid, and the Cochrane Center of Controlled Trials from inception to March 2023. The primary outcome was factors linked to dupilumab response in AD. The odds ratios and 95% CIs related to a 75% reduction at 12 to 16 weeks in the Eczema Area and Severity Index (EASI) score were synthesized using a random-effects meta-analysis. Results: Of 21 studies involving 5,575 patients with AD, three were post hoc analyses of phase 3 dupilumab studies, 12 were retrospective, and six were prospective studies. Factors associated with favorable responses to dupilumab, defined by the percentage of patients achieving EASI75 at 12 to 16 weeks, included female sex (OR [95% CI] = 2.16 [1.38-3.38]), young age (2.81 [1.64-4.81]), absence of allergic rhinitis (2.64 [1.07-6.50]), low body mass index (1.97 [1.18-3.30]), and low blood eosinophil count (6.47 [3.36-12.48]), with very low certainty of evidence. Age at onset, baseline EASI score, total IgE level, and serum lactate dehydrogenase level were unrelated to dupilumab response. Conclusions: Female sex, young age, absence of allergic rhinitis, low body mass index, and low blood eosinophil count were associated with a favorable response to dupilumab in patients with AD. These factors should be taken into account when considering dupilumab therapy in clinical practice.