Evaluation of atopic dermatitis severity indices in patients receiving IL-4, IL-13 inhibitor therapy (dupilumab) in combination with topical treatment methods

Rusakova L.L., Murashkin N.N.

1) National Medical Research Center for Children’s Health, Moscow, Russia; 2) I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; 3) Central State Medical Academy of the Administrative Directorate of the President of the Russian Federation, Moscow, Russia

Objective. Evaluation of the dermatological life quality indices (DLQI) and eczema severity (POEM) in patients receiving interleukin-4 (IL-4), IL-13 inhibitor therapy (dupilumab – DUP) in combination with topical treatment methods to develop a comprehensive algorithm for the treatment and prevention of exacerbations of atopic dermatitis (AD) in children with moderate and severe forms of the disease.
Methods. The study involved 120 children with AD, who were divided into 3 groups of 40 patients: in the group 1, patients received an IL-4 inhibitor, IL-13, topical glucocorticosteroid (TGCS), then emollients (EMOL); in the group 2 - an IL-4 inhibitor, IL-13, TGCS, followed by a switch to a topical calcineurin inhibitor (TCI) in combination with emollients according to the scheme; in the group 3 - an IL-4 inhibitor, IL-13 and emollients, with an assessment of the effectiveness of treatment and prevention of exacerbations according to the EASI and DLQI scales at the 16th, 28th, 52nd, 64th, 104th weeks of follow-up.
Results. As a result of the dynamic assessment of the DLQI and POEM indices, stabilization of these indicators was noted by the 16th and 28th weeks. However, starting from the 52nd week of follow-up, the group 2 with the DUP+TCI+EMOL program demonstrated the greatest efficiency, the DUP+TGCS+EMOL program was in second place in terms of efficiency, and the DUP+EMOL program showed the least efficiency.
Conclusion. The conducted study, based on the DLQI and POEM indices, demonstrated significant clinical efficacy and safety of therapy, prevention of exacerbations in children with moderate and severe forms of AD who received therapy with an IL-4, IL-13 inhibitor (dupilumab) in combination with topical treatment methods in the regimen of TGCS – 1 time per day for 2 weeks, then TCI – 2 times per day up to 16 weeks, then TCI – 2 times per week + EMOL up to 104 weeks in children over 2 years old.

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About the Authors

Corresponding author: Nikolay N. Murashkin, Dr. Sci. (Med.), Professor, Head of the Research Institute of Pediatric Dermatology, Head of the Department of Dermatology and Allergology, Head of the Laboratory of Skin Pathology in Children, Department of Scientific Research in Pediatrics, National Medical Research Center for Children’s Health; Professor, Department of Dermatovenereology and Cosmetology, Central State Medical Academy of the Administrative Directorate of the President of the Russian Federation, Professor, Department of Pediatrics and Pediatric Rheumatology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; m_nn2001@mail.ru

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