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, Lisa A Beck University of Rochester Medical Center , Rochester, NY , USA Search for other works by this author on: Oxford Academic Eric L Simpson Oregon Health & Science University , Portland, OR , USA Search for other works by this author on: Oxford Academic Michele Ramien Alberta Children’s Hospital , Calgary, AB , Canada University of Calgary , Calgary, AB , Canada Search for other works by this author on: Oxford Academic Mark Tang Mount Alvernia Medical Centre , Singapore Search for other works by this author on: Oxford Academic Joel C Joyce Endeavor Health , Skokie, IL , USA Search for other works by this author on: Oxford Academic Amy Praestgaard Sanofi , Cambridge, MA , USA Search for other works by this author on: Oxford Academic AnaB Rossi Sanofi , Cambridge, MA , USA Search for other works by this author on: Oxford Academic Drew Clearfield Regeneron Pharmaceuticals Inc. , Tarrytown, NY , USA Search for other works by this author on: Oxford Academic Annie Zhang Sanofi , Cambridge, MA , USA Search for other works by this author on: Oxford Academic
British Journal of Dermatology, Volume 191, Issue Supplement_2, August 2024, ljae266.060, https://doi.org/10.1093/bjd/ljae266.060
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08 August 2024
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Lisa A Beck, Eric L Simpson, Michele Ramien, Mark Tang, Joel C Joyce, Amy Praestgaard, AnaB Rossi, Drew Clearfield, Annie Zhang, 686 - Impact of dupilumab treatment on seasonal disease severity in adults with moderate-to-severe atopic dermatitis, British Journal of Dermatology, Volume 191, Issue Supplement_2, August 2024, ljae266.060, https://doi.org/10.1093/bjd/ljae266.060
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Abstract
Introduction/Background
Seasonal trends in atopic dermatitis (AD)-related healthcare visits vary by geographical location and climate. Changes in temperature, moisture, and allergens contribute to disease fluctuation activities throughout the year. The global, placebo-controlled, 1-year LIBERTY AD CHRONOS study (NCT02260986) offers the opportunity to evaluate AD seasonality and the impact of dupilumab on moderate-to-severe AD in adults regardless of season.
Objectives
To identify seasonal trends in patient-reported AD severity and frequency of symptoms, and to report the effect of dupilumab treatment in adults with moderate-to-severe AD across seasons.
Methods
CHRONOS was a randomized, double-blind, phase 3 trial of adults with moderate-to-severe AD.1 Patients were treated with dupilumab 300 mg every week (qw), every two weeks (q2w), or placebo qw, all with concomitant topical corticosteroids (TCS). In this post hoc analysis, the proportion of patients per severity category of Patient-Oriented Eczema Measure (POEM) score (range 0–28) by month was compared between patients receiving dupilumab 300 mg q2w + TCS (n = 79) or placebo qw + TCS (n = 234) for 1 year across 10 countries in the Northern Hemisphere. Improvement in AD was determined as an increase in proportion of patients with mild and clear POEM scores (≤7). Meteorological seasons were defined as winter (December 1 – February 28/29), spring (March 1 – May 31), summer (June 1 – August 31), and fall (September 1 – November 30). Sensitivity analyses confirmed that season of enrollment was balanced across treatment arms and disease seasonality was independent of treatment length. P values are based on Chi-Square tests or Monte Carlo simulations of the Exact Test, based on sample size. All P values are nominal, and no adjustments have been made for multiple testing. Data are presented as observed.
Results
The proportion of patients in both treatment arms with mild and clear POEM scores (≤7) was lowest in spring months (March: 13% vs 24%; April: 10% vs 23%; May: 20% vs 44%; placebo vs dupilumab). The proportion of patients with mild and clear POEM scores was increased through summer (June: 21% vs 54%; July: 24% vs 58%; August: 29% vs 53%; placebo vs dupilumab) and fall (September: 27% vs 62%; October: 23% vs 58%; November: 21% vs 63%; placebo vs dupilumab), before beginning to decline in winter (December: 21% vs 56%; January: 16% vs 46%; February: 15% vs 41%; placebo vs dupilumab). Overall, POEM scores indicated significantly better outcomes for patients receiving dupilumab treatment vs placebo throughout the year (overall P < 0.01 for all 12 months).
Conclusions
Across the Northern Hemisphere, patient-reported disease severity in adults with moderate-to-severe AD was greatest in the spring months. Adults with moderate-to-severe AD receiving dupilumab treatment reported improvement in frequency of disease symptoms across all seasons compared to patients receiving placebo treatment.
seasonality, atopic dermatitis, patient-oriented eczema measure, dupilumab, Northern Hemisphere
© The Author(s) 2024. Published by Oxford University Press on behalf of British Association of Dermatologists. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights)
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