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Papers of the Week

Papers: 18 Jul 2020 - 24 Jul 2020

Pharmacology/Drug Development


2020 Jul 21


Efficacy and safety of dupilumab for moderate-to-severe atopic dermatitis: a systematic review for the EAACI Biologicals Guidelines.


Agache I, Song Y, Posso M, Alonso-Coello P, Rocha C, Solà I, Beltran J, Akdis C, Akdis M, Brockow K, Chivato T, Del Giacco S, Eiwegger T, Eyerich K, Giménez-Arnau A, Gutermuth J, Guttman-Yassky E, Maurer M, Ogg G, Ong PY, et al.
Allergy. 2020 Jul 21.
PMID: 32691892.


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), 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 adults, together with more efficacy data in the paediatric population.