■目前关于dupilumab药物存活率(DS)的数据有限,尤其是可能与停药有关的因素。
■这项研究的主要终点是评估可能决定药物停药的参数以及与dupilumabDS相关的预测因素。我们认为是独立的相关因素:儿童疾病的发作,性别,AD的发病年龄,dupilumab的起始年龄,以前使用环孢菌素,初始平均EASI,特应性家族史,和过敏性结膜炎的易感性.
■在413名患者中,1年时DS为94.5%,2年的89.5%,3年时占83.7%,平均随访40.5个月(±1.6)后,有53例患者永久停药(12.8%).单变量分析显示,与药物存活率降低相关的唯一因素是过敏性结膜炎的易感性(p0.009)。在多变量cox回归男性(HR,2.34;95%CI,1.14-4.78;p0.02)和过敏性结膜炎的易感性(HR,2.61;95%CI,1.37-5.00;p0.004)与dupilumab较低的DS相关。
■男性和过敏性结膜炎的易感性是维持dupilumab治疗反应的阴性预测因子,因此与较低的DS率相关。
UNASSIGNED: There are currently limited data on dupilumab drug survival (DS), especially on factors possibly associated with drug discontinuation.
UNASSIGNED: The primary endpoint of this study is to evaluate the parameters that may determine drug discontinuation and the predictive factors associated with dupilumab DS. We considered as independent associated factors: childhood onset of disease, gender, age of onset of AD, age of initiation of dupilumab, previous use of cyclosporine, initial mean EASI, atopic family history, and predisposition to allergic conjunctivitis.
UNASSIGNED: On 413 patients DS was 94.5% at 1 year, 89.5% at 2 years, and 83.7% at 3 years, and after a mean follow-up of 40.5 months (±1.6) 53 patients had discontinued the drug permanently (12.8%). Univariate analysis showed that the only factor associated with a reduction in drug survival was a predisposition to allergic conjunctivitis (p 0.009). At multivariate Cox regression, male sex (HR, 2.34; 95% CI, 1.14-4.78; p 0.02) and predisposition to allergic conjunctivitis (HR, 2.61; 95% CI, 1.37-5.00; p 0.004) were associated with lower DS of dupilumab.
UNASSIGNED: Male gender and predisposition to allergic conjunctivitis are negative predictors for maintenance of response to treatment with dupilumab and consequently associated with lower DS rates.