The following is a summary of “Fast itch relief during dupilumab predicts clinical efficacy in bullous pemphigoid, a retrospective cohort study,” published in the July 2024 issue of Dermatology by Thevan et al.

Dupilumab shows promise as a treatment for bullous pemphigoid (BP), and promptly identifying responders could reduce the need for additional immunosuppressive therapies linked to higher morbidity and mortality.

Researchers conducted a retrospective study assessing itch as an early predictor of treatment response in patients with dupilumab.

They analyzed data from 12 patients treated with dupilumab at the University Hospital of Zurich. Disease severity was measured using the Bullous Pemphigoid Disease Area Index (BPDAI), and pruritus was evaluated with a numeric rating scale (NRS, 0-10) at baseline, days 1, 3, and 14, and months 1, 2, and the final follow-up.

The result showed that in 12 patients receiving dupilumab, 8 (67%) achieved a complete response, while 4 (33%) experienced a partial response. A highly significant reduction in pruritus (P<0.0001) was noted as early as day 1, with continued improvement at subsequent time points. Rapid relief of itch was a predictor of treatment response, showing a significant correlation with clinical response by day 14 (Spearman correlation R = 0.70, P=0.025) and a positive but non-significant trend by day 3 (R = 0.63, P=0.091). At the final follow-up, 92% (11/12) of patients were on dupilumab monotherapy without additional systemic or topical treatments for BP.

Investigators concluded that rapid reduction in pruritus with dupilumab, closely linked to disease remission, could transform BP treatment and minimize the need for extra immunosuppressives.

Source: karger.com/drm/article/doi/10.1159/000540590/910812/Fast-itch-relief-during-dupilumab-predicts