Comparison of real-world treatment outcomes of systemic immunomodulating therapy in atopic dermatitis patients with dark and light skin types.
Comparison of real-world treatment outcomes of systemic immunomodulating therapy in atopic dermatitis patients with dark and light skin types.
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DOI：
10.1016/j.jdin.2022.09.006
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发表时间：
2023-03
影响因子：
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通讯作者：
Middelkamp-Hup, Maritza A
中科院分区：
文献类型：
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作者：
Bosma, Angela L;Ouwerkerk, Wouter;Heidema, Madeline J;Prieto-Merino, David;Ardern-Jones, Michael R;Beattie, Paula;Brown, Sara J;Ingram, John R;Irvine, Alan D;Ogg, Graham;Patel, Prakash;Reynolds, Nick J;Hearn, R M Ross;Wan, Mandy;Warren, Richard B;Woolf, Richard T;Hyseni, Arienna M;Gerbens, Louise A A;Spuls, Phyllis I;Flohr, Carsten;Middelkamp-Hup, Maritza A
关于不同皮肤类型的特应性皮炎患者的治疗有效性和安全性差异的数据很少。旨在研究 dupilumab、甲氨蝶呤和环孢素的治疗结果以及特应性皮炎患者的形态表型（按 Fitzpatrick 皮肤类型分层）。在一项观察性前瞻性队列研究中，汇集了荷兰 TREAT（特应性湿疹治疗）NL (treatregister.nl) 和英国-爱尔兰 A-STAR（特应性湿疹系统治疗登记册；astar-register.org）登记处的数据、形态学表型和治疗结果的数据。总共纳入 235 名患者（浅色皮肤类型 [LST]：Fitzpatrick 皮肤类型 1-3，n = 156 [种族，白人：94.2%]；深色皮肤类型 [DST]：皮肤类型 4-6，n = 68 [黑人/非裔加勒比人：25%，南亚人：26.5%，西班牙裔：0%]）。 DST 更年轻（19.5 岁 vs 29.0 岁；P < .001），更常见毛囊性湿疹（22.1% vs 2.6%；P < .001），基线湿疹面积和严重程度指数 (EASI) 评分较高（20.1 vs 14.9；P = .009），过敏性接触性皮炎较少（30.9% vs 2.6%） 47.4%；P = .03)，以及之前的数据 光疗使用（39.7% vs 59.0%；P = .008）。当比较 DST 和 LST 校正协变量（包括基线 EASI）时，DST 显示基线与仅使用 dupilumab 的 6 个月之间平均 EASI 降低幅度更大（16.7 与 9.7；调整后 P = .032）。任何治疗的不良事件均未发现差异 (P > .05)。非盲、非随机。 LST 和 DST 之间的特应性皮炎在几个特征上有所不同。皮肤类型可能会影响 dupilumab 的治疗效果。
Few data exist on differences in treatment effectiveness and safety in atopic dermatitis patients of different skin types. To investigate treatment outcomes of dupilumab, methotrexate, and ciclosporin, and morphological phenotypes in atopic dermatitis patients, stratified by Fitzpatrick skin type. In an observational prospective cohort study, pooling data from the Dutch TREAT (TREatment of ATopic eczema) NL (treatregister.nl) and UK-Irish A-STAR (Atopic eczema Systemic TherApy Register; astar-register.org) registries, data on morphological phenotypes and treatment outcomes were investigated. A total of 235 patients were included (light skin types [LST]: Fitzpatrick skin type 1-3, n = 156 [Ethnicity, White: 94.2%]; dark skin types [DST]: skin type 4-6, n = 68 [Black African/Afro-Caribbean: 25%, South-Asian: 26.5%, and Hispanics: 0%]). DST were younger (19.5 vs 29.0 years; P < .001), more often had follicular eczema (22.1% vs 2.6%; P < .001), higher baseline Eczema Area and Severity Index (EASI) scores (20.1 vs 14.9; P = .009), less allergic contact dermatitis (30.9% vs 47.4%; P = .03), and less previous phototherapy use (39.7% vs 59.0%; P = .008). When comparing DST and LST corrected for covariates including baseline EASI, DST showed greater mean EASI reduction between baseline and 6 months with only dupilumab (16.7 vs 9.7; adjusted P = .032). No differences were found for adverse events for any treatments (P > .05). Unblinded, non-randomized. Atopic dermatitis differs in several characteristics between LST and DST. Skin type may influence treatment effectiveness of dupilumab.