Publicaciones científicas
Real-World Evaluation of the Effectiveness and Safety of Dupilumab in Bullous Pemphigoid: An Ambispective Multicenter Case Series
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.
CITA DEL ARTÍCULO Br J Dermatol. 2024 Oct 17:ljae403. doi: 10.1093/bjd/ljae403
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