Risk Factors Associated with Weight Gain During Treatment with Dupilumab Among Patients with Moderate to Severe Atopic Dermatitis

Overview

Journal Acta Derm Venereol

Specialty Dermatology

Date 2024 Nov 15

PMID 39545373

Authors

Mahsa Tayefi

Axel Svedbom

Lina Ivert

Maria Lundqvist

Jorge Ruas

Maria Bradley

Emma Johansson

Affiliations

Soon will be listed here.

Abstract

This cohort study used prospectively collected data from the Swedish national quality registry, SwedAD, to investigate weight gain as a possible side effect of dupilumab treatment for atopic dermatitis. Patients on dupilumab were compared with patients on other systemic medications, e.g., methotrexate, cyclosporine, or Janus kinase inhibitors, and possible risk factors for weight change during treatment with dupilumab were analysed. All patients aged 18 years or above, included in SwedAD between March 2018 and April 2023, who initiated systemic treatment at or after inclusion and had data on weight at baseline and at least 1 follow-up weight measurement were included (n = 157). After 2 years on dupilumab, patients had a mean weight gain of 1.6 kg (p = 0.007, 95% confidence interval [CI] 0.4-2.7). In the multivariable analysis, controlling for age at start, sex, asthma, and body mass index at start, dupilumab was associated with higher weight gain than other systemic treatments (3.3 kg, p = 0.005 [95% CI 1.0-5.6]). Asthma was associated with weight loss; male sex tended to be associated with weight gain.

References

Reich A, Riepe C, Anastasiadou Z, Medrek K, Augustin M, Szepietowski J . Itch Assessment with Visual Analogue Scale and Numerical Rating Scale: Determination of Minimal Clinically Important Difference in Chronic Itch. Acta Derm Venereol. 2016; 96(7):978-980. DOI: 10.2340/00015555-2433. View

Rohner M, Thormann K, Cazzaniga S, Yousefi S, Simon H, Schlapbach C . Dupilumab reduces inflammation and restores the skin barrier in patients with atopic dermatitis. Allergy. 2020; 76(4):1268-1270. DOI: 10.1111/all.14664. View

Castro M, Corren J, Pavord I, Maspero J, Wenzel S, Rabe K . Dupilumab Efficacy and Safety in Moderate-to-Severe Uncontrolled Asthma. N Engl J Med. 2018; 378(26):2486-2496. DOI: 10.1056/NEJMoa1804092. View

Finlay A, Khan G . Dermatology Life Quality Index (DLQI)--a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994; 19(3):210-6. DOI: 10.1111/j.1365-2230.1994.tb01167.x. View

Darkhal P, Gao M, Ma Y, Liu D . Blocking high-fat diet-induced obesity, insulin resistance and fatty liver by overexpression of Il-13 gene in mice. Int J Obes (Lond). 2015; 39(8):1292-9. PMC: 4595909. DOI: 10.1038/ijo.2015.52. View

Langan S, Irvine A, Weidinger S . Atopic dermatitis. Lancet. 2020; 396(10247):345-360. DOI: 10.1016/S0140-6736(20)31286-1. View

Bieber T, Paller A, Kabashima K, Feely M, Rueda M, Ross Terres J . Atopic dermatitis: pathomechanisms and lessons learned from novel systemic therapeutic options. J Eur Acad Dermatol Venereol. 2022; 36(9):1432-1449. DOI: 10.1111/jdv.18225. View

Sadik A, Somarribas Patterson L, Ozturk S, Mohapatra S, Panitz V, Secker P . IL4I1 Is a Metabolic Immune Checkpoint that Activates the AHR and Promotes Tumor Progression. Cell. 2020; 182(5):1252-1270.e34. DOI: 10.1016/j.cell.2020.07.038. View

Alsterholm M, Svedbom A, Anderson C, Holm Sommar L, Ivert L, Josefson A . Establishment and Utility of SwedAD: A Nationwide Swedish Registry for Patients with Atopic Dermatitis Receiving Systemic Pharmacotherapy. Acta Derm Venereol. 2023; 103:adv7312. PMC: 10108712. DOI: 10.2340/actadv.v103.7312. View

10.

Agudelo L, Ferreira D, Cervenka I, Bryzgalova G, Dadvar S, Jannig P . Kynurenic Acid and Gpr35 Regulate Adipose Tissue Energy Homeostasis and Inflammation. Cell Metab. 2018; 27(2):378-392.e5. DOI: 10.1016/j.cmet.2018.01.004. View

11.

Svanborg P, Asberg M . A new self-rating scale for depression and anxiety states based on the Comprehensive Psychopathological Rating Scale. Acta Psychiatr Scand. 1994; 89(1):21-8. DOI: 10.1111/j.1600-0447.1994.tb01480.x. View

12.

Chovatiya R, Paller A . JAK inhibitors in the treatment of atopic dermatitis. J Allergy Clin Immunol. 2021; 148(4):927-940. PMC: 10166130. DOI: 10.1016/j.jaci.2021.08.009. View

13.

Charman C, Venn A, Ravenscroft J, Williams H . Translating Patient-Oriented Eczema Measure (POEM) scores into clinical practice by suggesting severity strata derived using anchor-based methods. Br J Dermatol. 2013; 169(6):1326-32. PMC: 3920642. DOI: 10.1111/bjd.12590. View

14.

Han J, Nguyen J, Kim Y, Geng B, Romanowski G, Alejandro L . Effect of inhaled corticosteroid use on weight (BMI) in pediatric patients with moderate-severe asthma. J Asthma. 2018; 56(3):263-269. DOI: 10.1080/02770903.2018.1455853. View

15.

Nettis E, Masciopinto L, Di Leo E, De Candia N, Albanesi M, Di Bona D . Dupilumab elicits a favorable response in type-2 inflammatory comorbidities of severe atopic dermatitis. Clin Mol Allergy. 2021; 19(1):9. PMC: 8207639. DOI: 10.1186/s12948-021-00144-x. View

16.

Midttun O, Hustad S, Ueland P . Quantitative profiling of biomarkers related to B-vitamin status, tryptophan metabolism and inflammation in human plasma by liquid chromatography/tandem mass spectrometry. Rapid Commun Mass Spectrom. 2009; 23(9):1371-9. DOI: 10.1002/rcm.4013. View

17.

Rao R, Long J, White J, Svensson K, Lou J, Lokurkar I . Meteorin-like is a hormone that regulates immune-adipose interactions to increase beige fat thermogenesis. Cell. 2014; 157(6):1279-1291. PMC: 4131287. DOI: 10.1016/j.cell.2014.03.065. View

18.

Tournadre A, Pereira B, Dutheil F, Giraud C, Courteix D, Sapin V . Changes in body composition and metabolic profile during interleukin 6 inhibition in rheumatoid arthritis. J Cachexia Sarcopenia Muscle. 2017; 8(4):639-646. PMC: 5566648. DOI: 10.1002/jcsm.12189. View

19.

Ascott A, Mansfield K, Schonmann Y, Mulick A, Abuabara K, Roberts A . Atopic eczema and obesity: a population-based study. Br J Dermatol. 2020; 184(5):871-879. DOI: 10.1111/bjd.19597. View

20.

Leshem Y, Hajar T, Hanifin J, Simpson E . What the Eczema Area and Severity Index score tells us about the severity of atopic dermatitis: an interpretability study. Br J Dermatol. 2015; 172(5):1353-7. DOI: 10.1111/bjd.13662. View