Dupilumab, immunomodulating drugs for atopic dermatitis, does not increase risk of severe COVID-19
Use of biologics and other potentially immunocompromising therapies for atopic dermatitis was associated with low risk of severe COVID-19, study finds.
Dupilumab (Dupixent) treatment in patients with atopic dermatitis was not linked to an increased risk of complications from COVID-19, according to late-breaking data presented at the 2022 annual meeting of the American Academy of Dermatology. Additionally, patients who received dupilumab monotherapy were found to have a lower risk of hospitalization due to COVID-19 than people taking other atopic dermatitis medications.
The international team of investigators found that the use of biologics and other potentially immunocompromising therapies for atopic dermatitis was associated with a low risk of severe COVID-19.
The study, “Outcomes after COVID-19 infection in patients with atopic dermatitis,” aimed to assess whether routine immunomodulatory therapies and new systemic therapies affect COVID-19 outcomes in patients with atopic dermatitis. .
The study authors noted that biologics targeting immune pathways may actually help reduce the development of significant inflammation found in severe cases of COVID-19. Notably, they stated that dupilumab’s role as an inhibitor of interleukins 4 and 13 (IL-4, IL-13) may confer a “protective effect in the context of COVID-19 infection.”
The SECURE-AD registry was launched to assess the impact of COVID-19 on treated and untreated patients with atopic dermatitis. The researchers evaluated 452 registry patients from 27 countries who were infected with COVID-19 between April 2, 2020 and October 31, 2021.
Among these patients, the mean age was 35.9 years, the median body mass index was 23.7, 52% were male, and the patients were mostly Caucasian and resided in Italy. About two-thirds (69%) were diagnosed with COVID-19 via a positive test, while the remaining patients were strongly suspected of having the virus during the early stages of the pandemic.
More than 120 patients received a single topical treatment for atopic dermatitis and approximately 220 patients received dupilumab. The other most commonly used therapies were methotrexate, other conventional systemic therapies, and combination systemic therapies.
Of the patients in the registry, 12.4% were admitted to the emergency room while sick with COVID-19, 9.5% were hospitalized, 1.8% were admitted to the intensive care unit and 1.4 % required ventilation. No patient observed in the assessment died from COVID-19.
Investigators found that 9.9% (n=13) of patients with atopic dermatitis who received topical therapy alone were hospitalized with COVID-19, compared to 2.3% (n=5) of patients who received dupilumab (OR, 4.65; 95% CI, 1.62 – 1:36 p.m.).
When adjusting for confounding variables, there was an even significantly higher risk of hospitalization for COVID-19 among those who received topical treatment (OR, 4.95; 95% CI, 1.31–18 .67) than for dupilumab. These odds were worse for patients with atopic dermatitis who received systemic corticosteroids (OR, 2.81; 95% CI, 0.15, 52.42) or other conventional systemic treatments (OR, 2.36; 95% CI, 0.22 – 24.77).
The highest hospitalization rates were seen in people who received systemic combination therapy, such as systemic corticosteroids; however, this only included 4 patients in total (50%). The researchers concluded that nonsteroidal immunosuppressive monotherapy was associated with a reduced risk of COVID-19 hospitalization for patients with atopic dermatitis compared to combined systemic therapy.