Different AD clinical courses in patients withdrawing
treatment compared to patients continuing therapy.
At timepoint 1 (lockdown phase), disease severity assessment of the
whole patient population showed: mean EASI score of 6.8 ±7.7, itch-NRS
of 2.6 ±2.2, sleep-NRS of 1.7 ±2.1, and self-assessment of AD severity,
AD-NRS of 2.5 ±2.1 (Table 4). During the study period, patients
experienced a significant reduction of mean itch-NRS, mean sleep-NRS,
and mean AD-NRS scores, achieving lower mean scores at timepoint 3,
compared to timepoint 1 (Table S2 and Table S3). This improvement
reflected the significant decrease of mean EASI score at timepoint 3
(3.4 ± 4.4) compared to timepoint 1 (6.8 ± 7.7, p<0.0001).
Reduction of mean EASI score was observed in both patients continuing
treatment and patients interrupting systemic therapy, though at
different extent (Table 4). Indeed, mean EASI score changed in the
cohort of patients continuing treatment over time (6.6±7.8 at timepoint
1 vs. 2.8±3.4 at timepoint 3), obtaining a 10-fold higher reduction
compared to the cohort of patients withdrawing treatment (8.2±7.5 at
timepoint 1 vs. 7.3±7.7 at timepoint 3).
Self-assessment of itch, sleep and disease severity did not reveal any
marked difference between the two patient subcohorts in terms of score
reduction (Table 4).
At timepoint 1, AD improvement was experienced by a higher percentage of
patients continuing therapy compared to patients discontinuing treatment
(28.8% vs. 15.5%, p<0.001). Stable AD was reported by 60.9%
of patients continuing therapy compared to 48.6% of patients
interrupting therapy. On the contrary, an increased number of patients
discontinuing therapy described worsening of disease compared to
patients continuing therapy (35.9% vs. 10.3%). Similarly, AD status
perceived by patients continuing or interrupting therapy was
significantly different at the following timepoints (p<0.001;
Table 4). Comparing patients treated with dupilumab monotherapy,
dupilumab combined with other systemic therapies, and immunosuppressive
systemic compounds, a reduction of disease severity (EASI score, and NRS
scores) was detected at timepoint 3 vs. timepoint 1, as well as a
significantly different AD status across the three patient cohorts at
each time point (p<0.0001, Table S2). Patients treated with
dupilumab monotherapy showed lower disease activity at timepoint 1, with
a mean EASI score significantly lower compared to the other patients
(p<0.001), and this improvement was sustained thereafter
(Table S2).