Blood Cells Count Derived Inflammation Indexes as Predictors of Early Treatment Response to Dupilumab in Patients with Moderate-to-Severe Atopic Dermatitis

Angelo Zinellu, Federica Sucato, Viviana Piras, Gian Mario Addis, Gabriele Biondi, Maria Antonia Montesu, Arduino A. Mangoni, Ciriaco Carru, Pietro Pirina, Panagiotis Paliogiannis, Alessandro G. Fois, Rosanna Satta

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Abstract

Derived inflammatory indexes from routine hematological parameters might be useful for predicting early-response vs. late/non-response to dupilumab, the first biological agent approved for moderate-to-severe atopic dermatitis (AD). We tested this hypothesis by retrospectively investigating the association between pre-specified baseline inflammatory indexes and dupilumab response (≥50% reduction in the Eczema Area and Severity Index, EASI 50) at 4 and 16 weeks in a consecutive series of 66 AD patients (38 males and 28 females). Forty-six patients (69.7%) were early-responders at 4 weeks, whereas the remaining twenty (30.3%) were late/non-responders at 16 weeks. In logistic regression, the platelet-to-lymphocyte ratio (PLR) was independently associated with early-response (OR = 1.0159, 95% CI 1.0005 to 1.0315, p = 0.0426). The predictive performance of PLR and other derived indexes towards early-response was further improved by their combination with serum IgE concentrations, with a maximum AUC value for the combined systemic immune inflammation index (SII)-IgE of 0.797 (95% CI = 0.677 to 0.884, p < 0.0001). Derived inflammatory indexes, particularly SII-IgE, might be useful to identify early-responders to dupilumab and develop alternative treatment protocols for late/non-responders.

Original languageEnglish
Article number2104
Number of pages9
JournalJournal of Clinical Medicine
Volume12
Issue number6
DOIs
Publication statusPublished - 2 Mar 2023

Keywords

  • atopic dermatitis
  • blood cell count
  • dupilumab
  • IgE
  • platelet-to-lymphocyte ratio
  • treatment response

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