度普利尤单抗治疗成人特应性皮炎30例临床观察

Clinical observation of dupilumab in the treatment of 30 adult cases with atopic dermatitis

目的评估度普利尤单抗(dupilumab)对成人中重度特应性皮炎(AD)患者的临床疗效及生活质量的改善。方法收集2021年7月至2022年11月在北京市垂杨柳医院皮肤科接受度普利尤单抗治疗的成人中重度AD患者30例,疗程至少12周,比较治疗前后研究者整体评分(IGA)、湿疹面积及严重度指数(EASI)、AD评分(SCORAD)、瘙痒数值评分量表(NRS)、皮肤病生活质量指数(DLQI)、患者湿疹评估(POEM)、AD病情控制(ADCT)变化,记录不良反应。结果30例中重度成人AD患者IGA下降1分为96.7%,IGA≤2分为76.7%;EASI50为90%,EASI75为80%;NRS下降≥3分为100%,NRS≤4分为73.3%;DLQI下降≥4分为90%,DLQI≤5分为53.3%;POEM下降≥4分为96.7%,POEM≤7分为63.3%;ADCT下降≥5分为96.7%,ADCT≤7分为83.3%。不良反应2例,其中1例眼部发生结膜炎、睑缘炎,停药后眼科治疗好转;另1例发生躯干、四肢散在皮肤色素脱失,6个月后随访,大部分色素恢复正常。结论度普利尤单抗治疗成人中重度AD效果显著,不良反应小,显著改善患者生活质量。

Objective To evaluate the clinical efficacy and impact on quality of life of dupilumab in adults with moderate-to-severe atopic dermatitis(AD).Methods This study enrolled 30 adult patients with moderate-to-severe AD who received dupilumab treatment for a minimum of 12 weeks at Beijing Chuiyangliu Hospital’s dermatology department,from July 2021 to November 2022.The treatment outcomes were assessed by investigator’s global assessment(IGA),eczema area and severity index(EASI),scoring atopic dermatitis(SCORAD),peak pruritus numerical rating scale(NRS),patient oriented eczema measure(POEM),dermatology life quality index(DLQI),and atopic dermatitis control test(ADCT).Results 30 adults with moderate-to-severe AD were included in the study.IGA decreased by 1 point in 96.7%of cases,and IGA≤2 points accounted for 76.7%of cases;EASI50 was achieved in 90%of cases,and EASI75 in 80%of cases;NRS decline≥3 points was observed in 100%of cases,and NRS≤4 points in 73.3%of cases.DLQI decline≥4 points accounted for 90%of cases,and DLQI≤5 points accounted for 53.3%.POEM decline≥4 points was observed in 96.7%of cases,and POEM≤7 points accounted for 63.3%;ADCT decline≥5 points accounted for 96.7%of cases,and ADCT≤7 points accounted for 83.3%.Two cases of adverse reactions were observed in this study.One case developed ocular conjunctivitis and blepharitis,which improved after discontinuation of dupilumab treatment and subsequent ophthalmic treatment.The other case experienced depigmentation on the trunk and limbs,with significant improvement observed after a 6-month period.Conclusion The efficacy of dupriuzumab in the treatment of adults with moderate-to-severe AD is significant,accompanied by minimal adverse reactions,leading to a notable improvement in patients’quality of life.