Effect of COVID-19 (SARS-CoV-2) Vaccination on Patients with Atopic Dermatitis Treated with Dupilumab: A Multicenter, Observational Study
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Atopic dermatitis (AD) patients usually wonder if their condition will worsenafter vaccination or if they should continue with the treatment they are receiving. Consideringthat many patients treated with dupilumab had previously experienced severe ADsymptoms and flares, the concerns are more understandable. Objective: This study aimed to investigate the safety of the coronavirus disease 2019 (COVID-19) vaccination in patients with AD treated with dupilumab. Methods: We enrolled 133 patients (101 dupilumab-treated and 32 systemic oral agentstreatedas control group) with AD from six hospitals. Patients were asked about worseningpruritus and AD (5-point Likert scale) after vaccination. AD variables (eczema area and severityindex [EASI], investigator’s global assessment [IGA], itch numerical rating scale [NRS],sleep NRS, and patient-oriented eczema measure [POEM]) were compared pre- and postvaccination. Adverse reactions to the COVID-19 vaccination were observed. Results: The incidence of adverse reactions to COVID-19 vaccines and worsening ADsymptoms in dupilumab-treated patients were not significantly different compared with thatin the control group. The itch NRS score increased significantly after vaccination (p<0.001). However, there were no statistically significant differences between the pre-and post-EASI,IGA, and POEM scores. Eight patients (7.9%) had worse EASI scores and required rescuetherapy; however, most were easily managed with low-dose steroids or topical agents. Noneof the patients discontinued dupilumab treatment. Conclusion: No serious adverse reactions were observed in patients with AD after COVID-19 vaccination. Exacerbation of pruritus and AD symptoms was observed but wasmostly mild and transient.
Abstract
Background: Atopic dermatitis (AD) patients usually wonder if their condition will worsenafter vaccination or if they should continue with the treatment they are receiving. Consideringthat many patients treated with dupilumab had previously experienced severe ADsymptoms and flares, the concerns are more understandable. Objective: This study aimed to investigate the safety of the coronavirus disease 2019 (COVID-19) vaccination in patients with AD treated with dupilumab. Methods: We enrolled 133 patients (101 dupilumab-treated and 32 systemic oral agentstreatedas control group) with AD from six hospitals. Patients were asked about worseningpruritus and AD (5-point Likert scale) after vaccination. AD variables (eczema area and severityindex [EASI], investigator’s global assessment [IGA], itch numerical rating scale [NRS],sleep NRS, and patient-oriented eczema measure [POEM]) were compared pre- and postvaccination. Adverse reactions to the COVID-19 vaccination were observed. Results: The incidence of adverse reactions to COVID-19 vaccines and worsening ADsymptoms in dupilumab-treated patients were not significantly different compared with thatin the control group. The itch NRS score increased significantly after vaccination (p<0.001). However, there were no statistically significant differences between the pre-and post-EASI,IGA, and POEM scores. Eight patients (7.9%) had worse EASI scores and required rescuetherapy; however, most were easily managed with low-dose steroids or topical agents. Noneof the patients discontinued dupilumab treatment. Conclusion: No serious adverse reactions were observed in patients with AD after COVID-19 vaccination. Exacerbation of pruritus and AD symptoms was observed but wasmostly mild and transient.
참고문헌 (25)
- 이동훈, "Real-World Experience of Long-Term Dupilumab Treatment for Atopic Dermatitis in Korea", Annals of Dermatology, 34(2), pp.157~160 (2022), 대한피부과학회[DOI]
- Ring J, "Risk of severe allergic reactions to COVID-19 vaccines among patients with allergic skin diseases-practical recommendations. A position statement of ETFAD with external experts", J Eur Acad Dermatol Venereol, 35, pp.e362~e365 (2021)
- Thyssen JP, "European Task Force on Atopic Dermatitis : position on vaccination of adult patients with atopic dermatitis against COVID-19(SARS-CoV-2)being treated with systemic medication and biologics", J Eur Acad Dermatol Venereol, 35, pp.e308~e311 (2021)
- Blauvelt A, "Dupilumab does not affect correlates of vaccine-induced immunity : a randomized, placebo-controlled trial in adults with moderate-to-severe atopic dermatitis", J Am Acad Dermatol, 80, pp.158~167 (2019)
- Polack FP, "Safety and efficacy of the BNT162b2 mRNA COVID-19 vaccine", N Engl J Med, 383, pp.2603~2615 (2020)
- Baden LR, "Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine", N Engl J Med, 384, pp.403~416 (2021)
- Sun Q, "COVID-19 vaccines and the skin : the landscape of cutaneous vaccine reactions worldwide", Dermatol Clin, 39, pp.653~673 (2021)
- Sadoff J, "Safety and efficacy of single-dose Ad26. COV2. S vaccine against COVID-19", N Engl J Med, 384, pp.2187~2201 (2021)
- Pakhchanian H, "Examining the risk of breakthrough infection and COVID-19 vaccination safety in patients with atopic dermatitis", Br J Dermatol, 187, pp.251~253 (2022)
- Gambichler T, "Cutaneous findings following COVID-19 vaccination : review of world literature and own experience", J Eur Acad Dermatol Venereol, 36, pp.172~180 (2022)
- McMahon DE, "Cutaneous reactions reported after Moderna and Pfizer COVID-19 vaccination : a registry-based study of 414 cases", J Am Acad Dermatol, 85, pp.46~55 (2021)
- Bellinato F, "Cutaneous adverse reactions associated with SARS-CoV-2 vaccines", J Clin Med, 10, pp.5344~ (2021)
- Català A, "Cutaneous reactions after SARS-CoV-2 vaccination : a cross-sectional Spanish nationwide study of 405 cases", Br J Dermatol, 186, pp.142~152 (2022)
- Corbeddu M, "Transient cutaneous manifestations after administration of Pfizer-BioNTech COVID-19 Vaccine : an Italian single-centre case series", J Eur Acad Dermatol Venereol, 35, pp.e483~e485 (2021)
- Leasure AC, "Generalized eczematous reactions to the Pfizer-BioNTech COVID-19 vaccine", J Eur Acad Dermatol Venereol, 35, pp.e716~e717 (2021)
- Potestio L, "Atopic dermatitis exacerbation after COVID-19 vaccination in Dupilumab-treated patients", J Eur Acad Dermatol Venereol, 36, pp.e409~e411 (2022)
- Abuabara K, "The long-term course of atopic dermatitis", Dermatol Clin, 35, pp.291~297 (2017)
- Reed JL, "Eczema vaccinatum", Clin Infect Dis, 54, pp.832~840 (2012)
- Simonetti O, "Recommendations for dermatologists treating patients with atopic dermatitis during the Covid-19 pandemic : a look into the past for a conscious vaccination management", Hum Vaccin Immunother, 17, pp.3268~3275 (2021)
- Martorell A, "Position document: IgE-mediated allergy to egg protein", Allergol Immunopathol(Madr), 41, pp.320~336 (2013)
- Robert-Guroff M, "Replicating and non-replicating viral vectors for vaccine development", Curr Opin Biotechnol, 18, pp.546~556 (2007)
- Chavda VP, "Replicating viral vector-based vaccines for COVID-19 : potential avenue in vaccination arena", Viruses, 14, pp.759~ (2022)
- Leung DYM, "A clinical trial of intradermal and intramuscular seasonal influenza vaccination in patients with atopic dermatitis", J Allergy Clin Immunol, 139, pp.1575~1582 (2017)
- Law JC, "Systematic examination of antigen-specific recall T cell responses to SARS-CoV-2 versus influenza virus reveals a distinct inflammatory profile", J Immunol, 206, pp.37~50 (2021)
- Pfaar O, "COVID-19 vaccination of patients with allergies and type-2 inflammation with concurrent antibody therapy(biologicals)-a position paper of the German Society of Allergology and Clinical Immunology(DGAKI)and the German Society for Applied Allergology(AeDA)", Allergol Select, 5, pp.140~147 (2021)