Scientific publications
Real-World Evaluation of the Effectiveness and Safety of Dupilumab in Bullous Pemphigoid: An Ambispective Multicenter Case Series. Scientific Publication
Nidia Planella-Fontanillas 1 , Xavier Bosch-Amate 2 , Alicia Jiménez Antón 3 , Carlos Moreno-Vílchez 4 , María Gamo Guerrero 5 , María Del Mar Blanes Martínez 6 , M Asunción Ballester Martínez 7 , Patricia Bassas-Freixas 8 , Juan Luis Castaño Fernández 9 , Andrea Estébanez Corrales 10 , Ricardo Suarez Fernández 11 , Sergio Santos Alarcón 12 , Ana Bauzá Alonso 13 , Marina Torrent 14 , Adrian Ballano Ruiz 15 , Cristina Collantes Rodríguez 16 , Agustín España 17 , Eduardo Fonseca Capdevila 18 , Inmaculada Gil Faure 19 , Carlos Pelayo Hernández Fernández 20 , Francisco Javier Melgosa Ramos 21 , Jorge Spertino 22 , Violeta Zaragoza Ninet 23 , Lucia Armillas 24 , Isabel Bielsa 25 , Cristina Carrera 2 , Mireia Esquius Rafat 26 , Jon Fulgencio Barbarin 27 , Javier Fernandez Vela 28 , Miguel Lova Navarro 29 , Clara Martín Callizo 30 , Sara Martín-Sala 31 , Rosa Ojeda 32 , Maria Elisabet Parera Amer 33 , Anna Sánchez Puigdollers 34 , Ramon M Pujol 1 , Sebastian Podlipnik 2 , José Manuel Mascaró Jr 2 , Laia Curto-Barredo 1
Background: Bullous pemphigoid affects elderly individuals with multiple comorbidities, making conventional treatments unsuitable.
Objective: Evaluate the effectiveness and safety of dupilumab in the treatment of bullous pemphigoid.
Methods: A multicenter ambispective cohort study was conducted in 34 hospitals. Patients with bullous pemphigoid treated with Dupilumab were included. Most of patients (97.1%) received an initial 600 mg dose followed by 300 mg every two weeks.
Outcomes and measures: The primary outcome was the proportion of patients achieving complete remission within 4 weeks, defined as Investigator Global Assessment score of 0 or 1. Complete remission at weeks 16, 24, and 52, adverse events, reductions in peak pruritus numerical rating scale, and systemic glucocorticoid use were also assessed.
Results: The study included 103 patients with a median age of 77.3 years, 58.0% male. Complete remission was achieved by 53.4% within 4 weeks and 95.7% by week 52. Peak pruritus scale reduced by 70.0% by week 4 and was completely controlled by week 24. Thirteen patients presented adverse events, most of which were mild. Systemic glucocorticoid use reduced by 82.1% by week 52. Shorter disease duration and exclusive cutaneous involvement predicted better response at 16 weeks. No differences in response rates to dupilumab were observed between drug-associated bullous pemphigoid and idiopathic cases. No significant difference in response rates was observed between patients treated with dupilumab in monotherapy and those receiving dupilumab with concomitant treatments.
Conclusions: Dupilumab is effective, rapid, and safe in managing bullous pemphigoid, reducing the need for corticosteroids and other treatments. Early initiation and exclusive skin involvement predict better outcomes.
CITATION Br J Dermatol. 2024 Oct 17:ljae403. doi: 10.1093/bjd/ljae403
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