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The following is a summary of “Fast Itch Relief during Dupilumab Predicts Clinical Efficacy in Bullous Pemphigoid: A Retrospective Cohort Study,” published in the July 2024 issue of Dermatology by Thevan et al.
Dupilumab has become a potential treatment for bullous pemphigoid (BP). Quickly identifying patients who respond well to the treatment could help avoid the need for extra immunosuppressive therapies, which can lead to more health problems and even death.
Researchers conducted a retrospective study analyzing how quickly itching improved as an early sign of how well the treatment worked.
They examined data from 12 patients with BP treated with dupilumab at the University Hospital of Zurich. Disease severity was measured using the Bullous Pemphigoid Disease Area Index (BPDAI), and itching was rated on a scale from 0 to 10 numeric rating scale (NRS) at the beginning of the study, on days 1, 3, and 14, at months 1 and 2, and at the final follow-up appointment.
The results showed that 8 out of 12 patients (67%) had a complete response, and 4 out of 12 patients (33%) had a partial response to the dupilumab treatment. A very significant decrease in itching (P<0.0001) was observed as early as day 1, continuing to improve over time. The quick relief from itching was a good predictor of how well the treatment would work overall, showing a significant connection with clinical response by day 14 (Spearman correlation R 0.70, P-value 0.025) and a positive but not statistically significant trend on day 3 (R 0.63, P-value 0.091). Additionally, 92% (11 out of 12 patients) were only on dupilumab at the last follow-up, not needing any other systemic or topical treatment for BP.
They concluded that the fast and significant reduction in BP-related itching observed with dupilumab was strongly linked to the disease going into remission; checking how much itching improved early on could change how BP was treated in the future, potentially preventing the need for additional immunosuppressive treatments for BP.
Source: karger.com/drm/article/doi/10.1159/000540590/910812/Fast-Itch-Relief-during-Dupilumab-Predicts
