EASI-75 interpretation from a patient perspective – a phase 2b post-hoc analysis of dupilumab in adults with moderate-to-severe atopic dermatitis

Objective: To assess the relationship between achieving 75% reduction from baseline in Eczema Area and Severity Index (EASI-75) and patient-reported burden in patients with moderate-to-severe atopic dermatitis (AD) in a dupilumab phase 2b trial (NCT01859988).
Methods: Patients received subcutaneous dupilumab 100mg every 4 weeks (q4w), 300mg q4w, 200mg every 2 weeks (q2w), 300mg q2w, 300mg weekly (qw), or placebo for 16 weeks. This post-hoc analysis grouped patients based on EASI-75 achieved vs not achieved status at Week 16 (W16), regardless of treatment arm. Patient-reported outcomes included peak pruritus Numerical Rating Scale (NRS), SCOring AD Visual Analogue Scale (SCORAD VAS) sleep loss, Dermatology Life Quality Index (DLQI), and missed days of work/school.
Results: Across all treatment arms, 180 patients achieved EASI-75 at W16 and 174 did not. Mean EASI scores (standard deviation) at W16 were 3.156(0.653) and 19.350(0.664) for patients who achieved/did not achieve EASI-75, respectively. Patients who achieved EASI-75 had greater reductions in pruritus NRS (−3.76 vs −1.52), SCORAD VAS sleep loss (−4.05 vs −2.62), and DLQI (−9.7 vs −4.7) from baseline to W16, and fewer mean missed days of work/school (0.77 vs 4.02) (P<0.05 for all). A higher proportion of patients who achieved EASI-75 vs not achieved reported no impairment to certain aspects of patient life on individual DLQI items at W16 (P<0.05 for all).
Conclusions: In this study, achieving EASI-75 corresponded to substantial benefits across multiple aspects of patient burden associated with moderate-to-severe AD.
Data first presented at AAD 2017; March 3–7, 2017; Orlando, FL, USA.

Dr. Nicolas Martin