Papers of the Week

Atopic dermatitis (AD), a long-lasting skin disease characterized by intense itching and dry, red, swollen and cracked skin, affects between 2% and 10% of Japanese adults. In Japan, patients with moderate-to-severe or very severe AD have limited treatment options, most with unwanted side effects. There is a need for therapies that provide safe and effective long-term control. The underlying mechanism of AD may differ between Asian and Western patients, and this study aimed to evaluate dupilumab, a drug that blocks key molecules that cause AD, in Japanese patients with moderate-to-severe AD. The authors studied Japanese patients from three international, placebo-controlled clinical trials of dupilumab. Of the 1,597 adults with moderate-to-severe AD in those trials ("all patients"), 250 were Japanese. The investigators measured the effects of dupilumab treatment for 16 weeks or one year on the signs (what a clinician observes) and symptoms (what a patient feels) of AD. At the start of each trial, Japanese patients generally had more severe AD than all patients. Nevertheless, dupilumab significantly improved signs and symptoms of AD (including itch) compared with placebo (dummy drug) in the Japanese patients and was as well tolerated in the Japanese patients as in all patients; dupilumab was more likely than placebo to be associated with injection-site reaction or conjunctivitis ("pinkeye"). Compared with placebo, dupilumab reduced the amount of substances in the blood that are generally increased in patients with AD. The investigators concluded that, similar to all patients, dupilumab is effective and well tolerated in Japanese patients with moderate-to-severe AD.