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Dupilumab lowers some infection rates in moderate to severe atopic dermatitis

Dupilumab decreased the risk for serious or severe infection and nonherpetic skin infections in patients with moderate to severe atopic dermatitis compared with placebo, according to results published in the American Journal of Clinical Dermatology.

“In this pooled analysis, dupilumab- and placebo-treated patients did not significantly differ in their rates of overall infections or discontinuation due to infections, whereas serious or severe infections, skin infections and clinically important herpesviral infections (eczema herpeticum or herpes zoster) occurred at lower rates in the dupilumab groups than in the placebo group,” Lawrence F. Eichenfield, MD, of the departments of dermatology and pediatrics at the University of California, San Diego, and the division of pediatric and adolescent dermatology at Rady Children’s Hospital in San Diego, and colleagues wrote.

Of 2,932 patients with moderate to severe atopic dermatitis, 1,091 patients were randomly assigned to placebo, 1,095 to dupilumab (Dupixent, Regeneron/Sanofi) 300 mg weekly and 746 to dupilumab 300 mg every 2 weeks.

Dupilumab decreased the risk for serious or severe infections (number of patients per 100 person-years RR = 0.43; 95% CI, 0.22-0.85) compared with placebo, as well as bacterial and other nonherpetic skin infections (number of patients per 100 person-years RR = 0.44; 95% CI, .029-0.66), the researchers reported. However, the dupilumab treatment groups had similar infection rates overall per 100 patient-years and similar nonskin infection rates.

Additionally, the use of systemic anti-infective medication was lower with dupilumab compared with placebo, they wrote.

“Although herpesviral infection rates overall were slightly higher with dupilumab than placebo, clinically important herpesviral infections (eczema herpeticum, herpes zoster) were less common with dupilumab (RR = 0.31; P < .01),” the researchers wrote. – by Monica Jaramillo

Disclosures: The research was sponsored by Sanofi and Regeneron Pharmaceuticals. Eichenfield reports he receives honoraria for consulting services from Almirall, Celgene, Dermira, Dermavant, Eli Lilly and Company, Forté Pharma, Galderma, L’Oréal, Incyte, MatriSys, Menlo Therapeutics, Otsuka, Novan, Novartis, Pfizer, Regeneron Pharmaceuticals Inc., Sanofi Genzyme and Valeant/Ortho Dermatologics; and study support (to institution) from Celgene, Dermira, Dermavant, Eli Lilly and Company, Galderma, Incyte, Medimetriks, Pfizer, Regeneron Pharmaceuticals, Inc., Sanofi Genzyme, and Valeant. Please see the study for all other authors’ relevant financial disclosures.