PMID- 35696987
OWN - NLM
STAT- MEDLINE
DCOM- 20221107
LR  - 20221107
IS  - 1421-9832 (Electronic)
IS  - 1018-8665 (Linking)
VI  - 238
IP  - 6
DP  - 2022
TI  - Efficacy and Safety of Multiple Dupilumab Dose Regimens in Patients with 
      Moderate-To-Severe Atopic Dermatitis: A Systematic Review and Network 
      Meta-Analysis of Randomized Controlled Trials.
PG  - 1060-1072
LID - 10.1159/000524608 [doi]
AB  - BACKGROUND: Dupilumab ameliorates the signs and symptoms of atopic dermatitis 
      (AD) and improves the patient's quality of life. Multiple-dose regimens of 
      dupilumab have been applied by clinicians, but the efficacy of some regimens 
      remains unclear. OBJECTIVES: The aim of the study was to systematically evaluate 
      the efficacy and safety of multiple dupilumab dose regimens in patients with 
      moderate-to-severe AD in terms of comprehensive outcomes. METHODS: We searched 
      electronic databases and subjected the selected studies to risk-of-bias 
      assessment and network meta-analysis (NMA). Efficacy and safety outcomes were 
      compared using a random-effects NMA to estimate pooled relative risk ratio (RR) 
      of direct and indirect comparisons among multiple dupilumab dose regimens. The 
      Eczema Area Severity Index, Investigator's Global Assessment, and pruritus 
      numerical rating scale were analyzed to assess the efficacy, while adverse events 
      (AEs) and serious adverse events to represent the safety. RESULTS: Eight 
      randomized controlled trials involving 3,679 patients were identified. Most 
      patients received therapy for 16 weeks. Multiple dupilumab dose regimens, 
      including 300 mg weekly (QW), 300 mg every 2 weeks (Q2W), 200 mg Q2W, 300 mg 
      monthly (QM), 300 mg every 2 months (Q2M), and 100 mg QM were analyzed. All 
      regimens, except 100 mg QM, had significantly better efficacy than placebo. 300 
      mg QW and 300 mg Q2W appeared to have similar efficacy. Notably, both 300 mg QW 
      and 300 mg Q2W had no significantly better efficacy than 300 mg QM. As for 300 mg 
      Q2M, significantly reduced efficacy was noted in only one efficacy outcome when 
      compared to 300 mg QW and 300 mg Q2W. In terms of safety outcomes, AEs occurring 
      with any of the regimens were comparable with the placebo. No significant 
      inconsistency was noted within the network in all efficacy outcomes. CONCLUSIONS: 
      Our NMA indicated that the administration of the following dupilumab regimens was 
      effective for patients with moderate-to-severe AD: 300 mg QW, 300 mg Q2W, 200 mg 
      Q2W, 300 mg QM, and 300 mg Q2M. Our data can improve the understanding of the 
      relative efficacy and safety of multiple dupilumab dose regimens, which will help 
      in shared decision-making between clinicians and patients.
CI  - (c) 2022 S. Karger AG, Basel.
FAU - Shih, Ya-Chu
AU  - Shih YC
AD  - Department of Medical Education, Wan Fang Hospital, Taipei Medical University, 
      Taipei, Taiwan, chc72067@gmail.com.
FAU - Yeh, Marvin Chia-Han
AU  - Yeh MC
AD  - Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, 
      Taiwan.
FAU - Yang, Fu-An
AU  - Yang FA
AD  - School of Medicine, College of Medicine, Taipei Medical University, Taipei, 
      Taiwan.
FAU - Chen, Hung-Chou
AU  - Chen HC
AD  - Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical 
      University, Taipei, Taiwan.
AD  - Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei 
      Medical University, Taipei, Taiwan.
AD  - Department of Physical Medicine and Rehabilitation, School of Medicine, College 
      of Medicine, Taipei Medical University, Taipei, Taiwan.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20220613
PL  - Switzerland
TA  - Dermatology
JT  - Dermatology (Basel, Switzerland)
JID - 9203244
RN  - 420K487FSG (dupilumab)
SB  - IM
MH  - Humans
MH  - *Dermatitis, Atopic/drug therapy/diagnosis
MH  - Network Meta-Analysis
MH  - Quality of Life
MH  - Injections, Subcutaneous
MH  - Severity of Illness Index
MH  - Treatment Outcome
MH  - Randomized Controlled Trials as Topic
MH  - Double-Blind Method
OTO - NOTNLM
OT  - Atopic dermatitis
OT  - Dose
OT  - Dupilumab
OT  - Efficacy
EDAT- 2022/06/14 06:00
MHDA- 2022/11/08 06:00
CRDT- 2022/06/13 18:27
PHST- 2021/11/28 00:00 [received]
PHST- 2022/04/10 00:00 [accepted]
PHST- 2022/06/14 06:00 [pubmed]
PHST- 2022/11/08 06:00 [medline]
PHST- 2022/06/13 18:27 [entrez]
AID - 000524608 [pii]
AID - 10.1159/000524608 [doi]
PST - ppublish
SO  - Dermatology. 2022;238(6):1060-1072. doi: 10.1159/000524608. Epub 2022 Jun 13.