Date of Award

2018

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C

Abstract

Objective: The objective of this selective EBM review is to determine whether or not dupilumab is a safe and effective treatment for patients with moderate-to-severe atopic dermatitis

Study Design: Review of three randomized, double blind, placebo control trials between 2014- 2016.

Data Sources: Three randomized, double blind, placebo controlled trials were found via EBSCOHost and PubMed.

Outcomes Measured: In all three randomized controlled trials, outcomes measured includes the IGA score. Moderate-to-severe atopic dermatitis is a 3 or 4 on the IGA scale, respectively, while the goal was to get patients to a 0-1 on the IGA scale (indicating clear or almost clear disease state).

Results: Three double-blind, randomized controlled clinical trials evaluated the use of dupilumab 300mg SQ weekly vs. placebo in patients with moderate-to-severe atopic dermatitis. The study done by Beck, et al. showed that 40% of patients improved on an IGA scale from 3-4 to 0-1 compared to 7% in the control group. Simpson, et al. reported that 37% of patients improved to an IGA score of 0-1 compared to 10% in the control group. Thaçi, et al. had 33% of patients in that clinical trial with an IGA score of 0-1 compared to 2% in the control group.

Conclusions: Review of these articles suggests that dupilumab is beneficial in treating patients with moderate-to-severe atopic dermatitis whom failed topical intervention. Long term use of dupilumab needs to be evaluated more thoroughly in long term trials. Concomitant use of dupilumab with topical glucocorticoids also prompts further evaluation in improved patient outcomes.

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