Late-Breaking Data: Dupilumab Significantly Improves Signs, Symptoms, and QoL in Patients With Hand & Foot Dermatitis

Jonathan Silverberg, MD, PhD, MPH

“Atopic dermatitis of the hands and or feet is often chronic, difficult to treat, and substantially impacts patient's quality of life. In this study, we investigated the efficacy and safety of dupilumab in patients with atopic hand and foot dermatitis using dedicated clinical and patient-reported instruments,” began Jonathan Silverberg, MD, PhD, MPH, conference chair, as he presented late-breaking data from the phase 3 Liberty-AD-HAFT (NCT04417894) clinical trial at the 2023 Revolutionizing Atopic Dermatitis conference in Washington, DC.¹

Silverberg and fellow study investigators aimed to evaluate the safety and efficacy of dupilumab treatment in patients with atopic hand and foot dermatitis. From their findings, Silverberg et al determined “dupilumab rapidly and significantly improved signs, symptoms, and quality of life in patients with atopic hand and foot dermatitis. The safety profile was acceptable and was consistent with the known safety profile of dupilumab in the approved AD indication.”

Patients enrolled in the Liberty-AD-HAFT trial were adults and adolescents (≥ 12 years) meeting diagnostic criteria for atopic dermatitis (Hanifin and Rajka Diagnostic Criteria for Atopic Dermatitis), had chronic hand and/or foot eczema for at least 3 years for adults or 1 year for adolescents, had an overall Investigator Global Assessment (IGA) score for hands and foot of 3 or 4 (scale 0-4; 3 = moderate, 4 = severe), and had inadequate response or intolerance to topical corticosteroid use on atopic dermatitis lesions of the hand/foot. Patients were either treated with 300 mg Q2W (adults), 200/300 mg Q2W (adolescents), or placebo.

From the data, 40.3% of patients treated with dupilumab achieved the primary endpoint of a hand and foot IGA score of 0 or 1 compared to only 16.7% with placebo at week 16. Additionally, 52.2% of patients treated with dupilumab achieved a 4-point reduction in peak pruritis numerical rating scale (PP-NRS) at week 16. Patients treated with dupilumab also saw significant improvements in all secondary endpoints compared to placebo, including improved quality of life, pain, and sleep quality at week 16.

Patients with positive patch tests deemed to be clinically relevant, patients with documented exposure to irritants believed to be the predominant cause of the current hand and foot dermatitis, and patients treated with topical corticosteroids, topical calcineurin inhibitors, crisaborole, or topical Janus Kinase inhibitors (JAKi) on the hands and/or feet within 2 weeks before baseline were excluded from the study.

Reference

1. Simpson E, Silverberg J, Worm M, et al. Dupilumab treatment in patients with atopic hand and foot dermatitis: results from a phase 3, randomized, double-blind, placebo-controlled trial. Presented at the 2023 Revolutionizing Atopic Dermatitis Conference; April 29-May 1, 2023; Washington, DC. https://djbpnesxepydt.cloudfront.net/radv/April2023/April-2023-Posters/408_Poster_Dupilumab_Hand-and-Foot_Simpson-et-al_1682462329950.pdf