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Risk of COVID-19 and its complications in patients with atopic dermatitis undergoing dupilumab treatment-a population-based cohort study.
Kridin, Khalaf; Schonmann, Yochai; Solomon, Arie; Onn, Erez; Bitan, Dana Tzur; Weinstein, Orly; Cohen, Arnon D.
  • Kridin K; Lübeck Institute of Experimental Dermatology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany. dr_kridin@hotmail.com.
  • Schonmann Y; Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel. dr_kridin@hotmail.com.
  • Solomon A; Unit of Dermatology and Skin Research Laboratory, Baruch Padeh Medical Center, Poriya, Israel. dr_kridin@hotmail.com.
  • Onn E; Clalit Health Services, Tel-Aviv, Israel.
  • Bitan DT; Clalit Health Services, Tel-Aviv, Israel.
  • Weinstein O; Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.
  • Cohen AD; Baruch Padeh Medical Center, Poriya, Tiberias, Israel.
Immunol Res ; 70(1): 106-113, 2022 02.
Article in English | MEDLINE | ID: covidwho-1465909
ABSTRACT
The risk of coronavirus disease (COVID-19) infection and its complications among patients with atopic dermatitis (AD) treated by dupilumab is yet to be determined. We aimed to assess the risk of SARS-CoV-2 infection, COVID-19-associated hospitalization, and mortality among patients with AD treated by dupilumab. A population-based cohort study was conducted to compare AD patients treated by dupilumab (n = 238) with those treated by prolonged systemic corticosteroids (≥ 3 months; n = 1,023), phototherapy (n = 461), and azathioprine or mycophenolate mofetil (MMF; n = 194) regarding the incidence of COVID-19 and its complications. The incidence rate of COVID-19, COVID-19-associated hospitalization, and mortality among patients treated by dupilumab was 70.1 (95% CI, 40.5-116.4), 5.0 (95% CI, 0.3-24.7), and 0.0 per 1,000 person-year, respectively. The use of dupilumab was not associated with an increased risk of SARS-CoV-2 infection [adjusted HR for dupilumab vs. prolonged systemic corticosteroids 1.13 (95% CI, 0.61-2.09); dupilumab vs. phototherapy 0.80 (95% CI, 0.42-1.53); dupilumab vs. azathioprine/MMF 1.10 (95% CI, 0.45-2.65)]. Dupilumab was associated with a comparable risk of COVID-19-associated hospitalization [adjusted HR for dupilumab vs. prolonged systemic corticosteroids 0.35 (95% CI, 0.05-2.71); dupilumab vs. phototherapy 0.43 (95% CI, 0.05-3.98); dupilumab vs. azathioprine/MMF 0.25 (95% CI, 0.02-2.74)]. When applicable, the risk of mortality was not elevated in patients with AD treated by dupilumab [HR for dupilumab vs. prolonged systemic corticosteroids 0.04 (95% CI, 0.00-225.20)]. To conclude, dupilumab does not impose an increased risk of SARS-CoV-2 infection or COVID-19 complications in patients with AD. Dupilumab should be continued and considered as a safe drug for moderate-to-severe AD during the pandemic.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Dermatitis, Atopic / Antibodies, Monoclonal, Humanized / SARS-CoV-2 / COVID-19 / Hospitalization Type of study: Cohort study / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Immunol Res Journal subject: Allergy and Immunology Year: 2022 Document Type: Article Affiliation country: S12026-021-09234-z

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Dermatitis, Atopic / Antibodies, Monoclonal, Humanized / SARS-CoV-2 / COVID-19 / Hospitalization Type of study: Cohort study / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Immunol Res Journal subject: Allergy and Immunology Year: 2022 Document Type: Article Affiliation country: S12026-021-09234-z