Research Letter
104-week safety and effectiveness of dupilumab in the treatment of severe atopic dermatitis. The experience of 5 reference dermatology units in Spain
Read
5875
Timeswas read the article
2391
Total PDF
3484
Total HTML
Share statistics
array:24 [ "pii" => "S0365059621002300" "issn" => "03650596" "doi" => "10.1016/j.abd.2020.08.030" "estado" => "S300" "fechaPublicacion" => "2021-11-01" "aid" => "455" "copyright" => "Sociedade Brasileira de Dermatologia" "copyrightAnyo" => "2021" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "sco" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "pt" => array:19 [ "pii" => "S2666275221002368" "issn" => "26662752" "doi" => "10.1016/j.abdp.2020.08.020" "estado" => "S300" "fechaPublicacion" => "2021-11-01" "aid" => "455" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "sco" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "pt" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta ‐ Investigação</span>" "titulo" => "Segurança e eficácia de 104 semanas de dupilumabe no tratamento de dermatite atópica grave. A experiência de cinco unidades dermatológicas de referência na Espanha" "tienePdf" => "pt" "tieneTextoCompleto" => "pt" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "787" "paginaFinal" => "790" ] ] "contieneTextoCompleto" => array:1 [ "pt" => true ] "contienePdf" => array:1 [ "pt" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1366 "Ancho" => 2175 "Tamanyo" => 91016 ] ] "descripcion" => array:1 [ "pt" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Evolução do DLQI da linha de base até a semana 104. <span class="elsevierStyleItalic">DLQI</span>, <span class="elsevierStyleItalic">Dermatology Life Quality Index</span>.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jose Juan Pereyra‐Rodriguez, Javier Dominguez‐Cruz, Jose Carlos Armario‐Hita, Ricardo Ruiz‐Villaverde" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Jose Juan" "apellidos" => "Pereyra‐Rodriguez" ] 1 => array:2 [ "nombre" => "Javier" "apellidos" => "Dominguez‐Cruz" ] 2 => array:2 [ "nombre" => "Jose Carlos" "apellidos" => "Armario‐Hita" ] 3 => array:2 [ "nombre" => "Ricardo" "apellidos" => "Ruiz‐Villaverde" ] ] ] ] ] "idiomaDefecto" => "pt" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0365059621002300" "doi" => "10.1016/j.abd.2020.08.030" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059621002300?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275221002368?idApp=UINPBA00008Z" "url" => "/26662752/0000009600000006/v2_202111200533/S2666275221002368/v2_202111200533/pt/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S0365059621002257" "issn" => "03650596" "doi" => "10.1016/j.abd.2020.08.027" "estado" => "S300" "fechaPublicacion" => "2021-11-01" "aid" => "450" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "sco" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case Letter</span>" "titulo" => "Clinicodermoscopic and immunohistochemical observation of hepatitis B virus-associated acquired bilateral telangiectatic macules in a Chinese man" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "791" "paginaFinal" => "793" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1572 "Ancho" => 2924 "Tamanyo" => 379011 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Clinicodermoscopic features of ABTM: (a), Telangiectatic erythematous macules on the chest and upper limbs. (b), Dermoscopy revealing tortuous/arborizing vessels and diffuse brownish pigmentation on the chest (×30).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Zi-Wei Zhang, Hao Wu, Ke-Feng Tang, Yi-Ming Fan" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Zi-Wei" "apellidos" => "Zhang" ] 1 => array:2 [ "nombre" => "Hao" "apellidos" => "Wu" ] 2 => array:2 [ "nombre" => "Ke-Feng" "apellidos" => "Tang" ] 3 => array:2 [ "nombre" => "Yi-Ming" "apellidos" => "Fan" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2666275221002319" "doi" => "10.1016/j.abdp.2021.09.023" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275221002319?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059621002257?idApp=UINPBA00008Z" "url" => "/03650596/0000009600000006/v2_202111180901/S0365059621002257/v2_202111180901/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0365059621002142" "issn" => "03650596" "doi" => "10.1016/j.abd.2020.09.012" "estado" => "S300" "fechaPublicacion" => "2021-11-01" "aid" => "439" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "sco" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Research Letter</span>" "titulo" => "Efficacy of intermittent topical 5-fluorouracil 5% and oral nicotinamide in the skin field cancerization: a randomized clinical trial" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "784" "paginaFinal" => "787" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1459 "Ancho" => 2167 "Tamanyo" => 157221 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Actinic keratoses count at T0 and T120 for the oral nicotinamide, placebo, 5FU, and topical sunscreen groups: improvement in all groups with time, mainly in the group using topical 5FU.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Eliane Roio Ferreira, Anna Carolina Miola, Thania Rios Rossi Lima, Juliano Vilaverde Schmitt, Luciana Patricia Fernandes Abbade, Hélio Amante Miot" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Eliane Roio" "apellidos" => "Ferreira" ] 1 => array:2 [ "nombre" => "Anna Carolina" "apellidos" => "Miola" ] 2 => array:2 [ "nombre" => "Thania Rios Rossi" "apellidos" => "Lima" ] 3 => array:2 [ "nombre" => "Juliano Vilaverde" "apellidos" => "Schmitt" ] 4 => array:2 [ "nombre" => "Luciana Patricia Fernandes" "apellidos" => "Abbade" ] 5 => array:2 [ "nombre" => "Hélio Amante" "apellidos" => "Miot" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2666275221002204" "doi" => "10.1016/j.abdp.2021.09.012" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275221002204?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059621002142?idApp=UINPBA00008Z" "url" => "/03650596/0000009600000006/v2_202111180901/S0365059621002142/v2_202111180901/en/main.assets" ] "en" => array:17 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Research Letter</span>" "titulo" => "104-week safety and effectiveness of dupilumab in the treatment of severe atopic dermatitis. The experience of 5 reference dermatology units in Spain" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "787" "paginaFinal" => "790" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Jose Juan Pereyra-Rodriguez, Javier Dominguez-Cruz, Jose Carlos Armario-Hita, Ricardo Ruiz-Villaverde" "autores" => array:4 [ 0 => array:3 [ "nombre" => "Jose Juan" "apellidos" => "Pereyra-Rodriguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Javier" "apellidos" => "Dominguez-Cruz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Jose Carlos" "apellidos" => "Armario-Hita" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:4 [ "nombre" => "Ricardo" "apellidos" => "Ruiz-Villaverde" "email" => array:1 [ 0 => "ricardo.ruiz.villaverde.sspa@juntadeandalucia.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Dermatology Unit, Hospital Universitario Virgen del Rocio, Sevilla, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Dermatology Unit, Hospital Universitario Puerto Real, Cádiz, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Dermatology Unit, Hospital Universitario San Cecilio, Granada, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 446 "Ancho" => 1305 "Tamanyo" => 69275 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">16w after Dupilumab treatment (SCORAD 16).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Atopic Dermatitis (AD) is a multifactorial disease resulting from the interaction of genetic predisposition, environmental triggers, disruption of skin barrier function, and type 2 immune dysregulation. Management of mild forms of AD includes the use of emollients, topical corticosteroids or calcineurin inhibitors, and phototherapy, while systemic immunosuppressive agents such as oral corticosteroids and Cyclosporine A (CsA) are reserved for severe refractory cases.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Nevertheless, severe cases are usually not adequately controlled with any of these therapies, requiring a further step to reach clinical control.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Recently, FDA and EMA have authorized Dupilumab, a treatment targeting Th2 cytokines Il-4 and Il-13 which has shown to be effective to control the signs and symptoms of AD. Real-world experience with Dupilumab shows a similar effectivity as compared to randomized clinical trials, but it is yet to know how this drug will perform in the long term in routine medical practice.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3–5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We performed a retrospective chart review of 30 patients from 5 Andalusian reference dermatology units (Hospital Virgen del Rocio-Sevilla; Hospital Juan Ramon Jimenez-Huelva; Hospital Universitario de Puerto Real-Cadiz; Hospital Reina Sofía-Córdoba and Hospital Universitario San Cecilio-Granada) included in the Spanish compassionate use of Dupilumab for adult patients with moderate to severe AD from November 2017 to February 2020. According to the compassionate use program recommendations for dupilumab prescription, inclusion criteria were age ≥18 years, a severe disease defined by a baseline Eczema Area and Severity Index (EASI) ≥16, and inadequate response/intolerance to CsA or medical inadvisability of CsA treatment. Patients with any documented psychiatric comorbidity were excluded from the study.</p><p id="par0015" class="elsevierStylePara elsevierViewall">All patients were treated with subcutaneous dupilumab 300 mg every other week following a loading dose of dupilumab 600 mg. Concomitant topical corticosteroids or calcineurin inhibitors were allowed. All patients agreed with the treatment regimen and signed a written consent form to extract relevant data from their charts. Data collected included age, disease course, personal history (including comorbidities), and previous systemic/biological treatments. Disease severity was measured by Scoring Atopic Dermatitis (SCORAD) and Pruritus Visual Analog Scale (VAS) scores at the baseline visit, and at follow-up weeks 4, 12, 24, 52, 76, and 104. Quality of life was assessed with Dermatology Life Quality Index (DLQI).</p><p id="par0020" class="elsevierStylePara elsevierViewall">Baseline characteristics are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. The studied population presented a substantial burden of disease, with an average of 25.7 years of AD evolution. The most common comorbidities were allergic rhinitis (55.5%), asthma (37%), and conjunctivitis (33.4%). These comorbidities were more common in those patients with longer treatment with immunosuppressants. All patients had received previous treatment with oral corticosteroids, and 96.3% had been treated with cyclosporine.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> The effectiveness of the dupilumab treatment was assessed at weeks 4, 12, 24, 52, and 104. The mean percentage of change in SCORAD is shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, while DLQI evolution is shown in <a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>. At baseline, SCORAD was 59.4, while pruritus VAS was 8.3. In the follow-up week 104 visit, SCORAD decreased to 10.7 (-82%), and pruritus VAS reduced to 2.9 (-65%). Regarding QoL, the baseline DLQI value was 19, reaching 4.3 (-77.4%) at the same cut-off. The safety profile was favorable, reporting 3 cases of mild conjunctivitis, managed positively without suspension of Dupilumab. One example of treatment effect is shown at baseline (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>) and 16 weeks (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">This retrospective multicentric study on a cohort of 30 patients with severe AD implies the longer follow-up published to date on real-life experience with dupilumab and confirms the efficacy of this agent for refractory cases. A statistically significant reduction in SCORAD was achieved at week 4 and maintained through week 104. The clinical improvement was accompanied by a considerable amelioration of quality of life, as measured by DLQI, and the most bothersome symptom, itch, assessed with pruritus VAS. Dupilumab was well tolerated in most patients, with only 10% of patients suffering from conjunctivitis. These results are aligned with what was recorded in Clinical Trials but contrast with other real-world studies reporting eye symptoms in up to 62% of cases.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> From our experience, the use of lipid emulsion eye drops combined with hyaluronic acid eye drops as a prophylactic measure may have a protective effect against dry eyes and eye pruritus, which may have a key role in the development of conjunctivitis Injection-site reactions were not reported by our patients. Limitations of the study are its retrospective nature and the small sample size.</p><p id="par0030" class="elsevierStylePara elsevierViewall">To sum up, our real-life study confirmed that dupilumab is an effective treatment in patients with severe AD and provides the longest follow-up published to date.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial support</span><p id="par0035" class="elsevierStylePara elsevierViewall">None declared.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Author’s contributions</span><p id="par0040" class="elsevierStylePara elsevierViewall">Jose Juan Pereyra-Rodriguez: Acquisition of data; editing; study concept and design; writing; critical review.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Javier Dominguez-Cruz: Acquisition of data; editing; design; critical review.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Jose Carlos Armario-Hita: Acquisition of data; editing; design; critical review.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Ricardo Ruiz Villaverde: Acquisition of data; editing; study concept and design; writing; critical review.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0060" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Financial support" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Author’s contributions" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflicts of interest" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-04-20" "fechaAceptado" => "2020-08-24" "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">How to cite this article: Pereyra-Rodriguez JJ, Dominguez-Cruz J, Armario-Hita JC, Villaverde RR. 104-week safety and effectiveness of dupilumab in the treatment of severe atopic dermatitis. The experience of 5 reference dermatology units in Spain. An Bras Dermatol. 2021;96:787–90.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Study conducted at the Hospital Universitario San Cecilio, Granada, Spain.</p>" ] ] "multimedia" => array:5 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1184 "Ancho" => 2175 "Tamanyo" => 82410 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Mean percentage change in Scoring Atopic Dermatitis (SCORAD) from baseline through week 104 in patients treated with dupilumab.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1366 "Ancho" => 2175 "Tamanyo" => 83694 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">DLQI from baseline through week 104. DLQI, dermatology life quality index.</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 565 "Ancho" => 1305 "Tamanyo" => 86068 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Baseline state on one patient in our series (SCORAD 64).</p>" ] ] 3 => array:8 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 446 "Ancho" => 1305 "Tamanyo" => 69275 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">16w after Dupilumab treatment (SCORAD 16).</p>" ] ] 4 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0025" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Characteristic \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Average \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age, years (range) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40.4 (19–56) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sex (male, %) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">70% (21/30) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Years of AD evolution, years (range) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28.5 (10–44) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Comorbidities (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nasal polyps \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16.6% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Conjunctivitis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36.8% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Extrinsic asthma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22.2% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Allergic rhinitis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Alimentary allergies \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22.2% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Previous treatment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Oral systemic corticosteroids \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% (Average length: 23.7 months) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Oral cyclosporine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">94.4% (Average’s lengths: 19.8 months) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Phototherapy (NB-UVB) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33.3% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Baseline SCORAD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">59.4% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Baseline pruritus VAS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.3% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Baseline DLQI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2749614.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Patients’ baseline characteristics.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Atopic dermatitis in adults: a diagnostic challenge" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.F. Silvestre Salvador" 1 => "D. Romero-Pérez" 2 => "B. Encabo-Durán" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.18176/jiaci.0138" "Revista" => array:6 [ "tituloSerie" => "J Investig Allergol Clin Immunol" "fecha" => "2017" "volumen" => "27" "paginaInicial" => "78" "paginaFinal" => "88" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28071589" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Changing perspectives in atopic dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Serra-Baldrich" 1 => "J.O. de Frutos" 2 => "I. Jáuregui" 3 => "J.C. Armario-Hita" 4 => "J.F. Silvestre" 5 => "L. Herraez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Allergol Immunopathol" "fecha" => "2018" "volumen" => "46" "paginaInicial" => "397" "paginaFinal" => "412" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dupilumab: short-term effectiveness and security in real clinical practice – A retrospective multicentric study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R. Ruiz-Villaverde" 1 => "J. Dominguez-Cruz" 2 => "J.C. Armario-Hita" 3 => "L. Martinez-Pilar" 4 => "S. Alcantara-Luna" 5 => "J.J. Pereyra-Rodriguez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/jdv.15118" "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2019" "volumen" => "33" "paginaInicial" => "e21" "paginaFinal" => "e22" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29888527" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of moderate-to-severe atopic dermatitis with dupilumab in real clinical practice: a multicentre, retrospective case series" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.C. Armario-Hita" 1 => "J. Pereyra-Rodriguez" 2 => "J.F. Silvestre" 3 => "R. Ruiz-Villaverde" 4 => "A. Valero" 5 => "R. Izu-Belloso" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/bjd.18041" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2019" "volumen" => "181" "paginaInicial" => "1072" "paginaFinal" => "1074" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31021399" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical Response and Quality of Life in Patients with Severe Atopic Dermatitis Treated with Dupilumab: A Single-Center Real-Life Experience" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Ferrucci" 1 => "G. Casazza" 2 => "L. Angileri" 3 => "S. Tavecchio" 4 => "F. Germiniasi" 5 => "E. Berti" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "J Clin Med" "fecha" => "2020" "volumen" => "9" "paginaInicial" => "791" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03650596/0000009600000006/v2_202111180901/S0365059621002300/v2_202111180901/en/main.assets" "Apartado" => array:4 [ "identificador" => "82768" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Research Letter" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/03650596/0000009600000006/v2_202111180901/S0365059621002300/v2_202111180901/en/main.pdf?idApp=UINPBA00008Z&text.app=https://clinics.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059621002300?idApp=UINPBA00008Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 11 | 8 | 19 |
| 2024 October | 88 | 72 | 160 |
| 2024 September | 200 | 93 | 293 |
| 2024 August | 185 | 115 | 300 |
| 2024 July | 215 | 130 | 345 |
| 2024 June | 175 | 82 | 257 |
| 2024 May | 147 | 72 | 219 |
| 2024 April | 139 | 94 | 233 |
| 2024 March | 105 | 72 | 177 |
| 2024 February | 88 | 79 | 167 |
| 2024 January | 73 | 47 | 120 |
| 2023 December | 69 | 55 | 124 |
| 2023 November | 84 | 85 | 169 |
| 2023 October | 67 | 90 | 157 |
| 2023 September | 124 | 73 | 197 |
| 2023 August | 54 | 33 | 87 |
| 2023 July | 71 | 45 | 116 |
| 2023 June | 62 | 50 | 112 |
| 2023 May | 62 | 33 | 95 |
| 2023 April | 49 | 16 | 65 |
| 2023 March | 76 | 49 | 125 |
| 2023 February | 60 | 33 | 93 |
| 2023 January | 61 | 32 | 93 |
| 2022 December | 58 | 31 | 89 |
| 2022 November | 105 | 57 | 162 |
| 2022 October | 134 | 51 | 185 |
| 2022 September | 66 | 66 | 132 |
| 2022 August | 61 | 52 | 113 |
| 2022 July | 49 | 62 | 111 |
| 2022 June | 58 | 60 | 118 |
| 2022 May | 45 | 35 | 80 |
| 2022 April | 62 | 52 | 114 |
| 2022 March | 70 | 83 | 153 |
| 2022 February | 38 | 41 | 79 |
| 2022 January | 107 | 97 | 204 |
| 2021 December | 174 | 98 | 272 |
| 2021 November | 109 | 72 | 181 |
| 2021 October | 73 | 73 | 146 |
| 2021 September | 10 | 3 | 13 |
Show all
