Dupilumab Improves Skin Barrier Function in Adults with Atopic Dermatitis: A Prospective Observational Study

Abstract

settingsOrder Article Reprints Open AccessArticle Dupilumab Improves Skin Barrier Function in Adults with Atopic Dermatitis: A Prospective Observational Study by Trinidad Montero-Vilchez 1,2ORCID,Juan-Angel Rodriguez-Pozo 1,2,Pablo Diaz-Calvillo 1,2ORCID,Maria Salazar-Nievas 1,Jesús Tercedor-Sanchez 1,2ORCID,Alejandro Molina-Leyva 1,2,*ORCID andSalvador Arias-Santiago 1,2,3,4ORCID 1 Department of Dermatology, Virgen de las Nieves University Hospital, 18012 Granada, Spain 2 Biosanitary Institute of Granada (ibs.GRANADA), 18012 Granada, Spain 3 Cell Production and Tissue Engineering Unit, Virgen de las Nieves University Hospital, Andalusian Network of Design and Translation of Advanced Therapies, 18012 Granada, Spain 4 Department of Dermatology, Faculty of Medicine, University of Granada, 18071 Granada, Spain * Author to whom correspondence should be addressed. J. Clin. Med. 2022, 11(12), 3341; https://doi.org/10.3390/jcm11123341 Submission received: 2 May 2022 / Revised: 7 June 2022 / Accepted: 8 June 2022 / Published: 10 June 2022 (This article belongs to the Special Issue Atopic Dermatitis: Research and Clinical Updates and Perspectives) Downloadkeyboard_arrow_down Browse Figures Review Reports Versions Notes Abstract Epidermal barrier dysfunction plays an important role in atopic dermatitis (AD). The difficulty of objectively assessing AD severity and the introduction of new biologicals into clinical practice highlight the need to find parameters to monitor clinical outcomes. The aim of this study is to evaluate the impact of dupilumab on skin barrier function and compare it with other treatments in patients with AD. A prospective observational study was conducted in adults with AD treated with topical corticosteroids (TCS), cyclosporine, or dupilumab. The main outcome measures after 16 weeks of treatment were Eczema Area and Severity (EASI)-50 (50% improvement in EASI), and transepidermal water loss (TEWL)-50 (50% improvement in TEWL). Forty-six patients with AD were included in the study. The proportion of patients who achieved EASI-50 at week 16 was significantly higher in patients receiving dupilumab (81.8% vs. 28.6% vs. 40%, p = 0.004). In eczematous lesions, TEWL decreased in patients receiving dupilumab (31.02 vs. 12.10 g·h−1·m−2, p < 0.001) and TCS (25.30 vs. 14.88 g·h−1·m−2, p = 0.047). The proportion of patients who achieved TEWL-50 at week 16 was higher for dupilumab than for cyclosporine or TCS. Temperature only decreased in the dupilumab group. Stratum corneum hydration increased in eczematous lesions and non-involved skin only in patients with dupilumab. In conclusion, dupilumab improves skin barrier function in patients with AD better than TCS or cyclosporine, both in eczematous lesions and in non-lesioned skin.