Weight gain in patients with severe atopic dermatitis treated with dupilumab: a cohort study

Abstract Background Dupilumab, targeting the interleukin-4α receptor and inhibiting the action of interleukin-4 and interleukin-13, was recently approved for treatment of moderate to severe atopic dermatitis. There is limited data on long-term effects and safety among patients with severe atopic dermatitis treated with dupilumab. Weight gain was observed among patients treated with dupilumab in our clinic. The aim was to describe weight change in a cohort study of patients with severe atopic dermatitis treated with dupilumab from baseline to follow-up after 12 months, and to analyze if weight change was associated with effect of treatment, reported appetite, and/or disturbed night sleep due to itching.Methods All patients with atopic dermatitis receiving systemic treatment at the Unit of Dermatology, Karolinska University Hospital, have been registered and monitored consecutively since January 2017. This cohort constituted all patients who started treatment on dupilumab or methotrexate between 10 January 2017 and 30 June 2019 with at least 6 months of follow-up within the study period. The following variables were monitored at start of and during treatment: Eczema Severity Score Index, Patient-Oriented Eczema Measure, visual analogue scale for pruritus 10cm, Montgomery-Åsberg Depression Rating Scale, Dermatology Life Quality Index, and weight. Data analyses were performed using two-sample Wilcoxon-Mann-Whitney rank-sum test, or the Wilcoxon matched-pairs sign-rank test with a p-value <0.05 considered as statistically significant.Results Patients treated with dupilumab (n=12) gained weight (mean 6.1 kg, range [0.1–18.0], p=0.002) after one year on treatment. The majority of patients showed a good response to treatment with dupilumab (n=11); at follow-up at 6, 9, or 12 months, they reached EASI-90 (n=6), EASI-75 (n=4), or EASI-50 (n=1). There was no significant association between weight gain and treatment response, reported appetite, or disturbed night-sleep due to itch. Patients treated with methotrexate showed no significant weight change (n=8). Conclusions To our knowledge, this is the first report on a possible association between weight gain and dupilumab treatment; the extent of the association is yet to be seen, as is the mechanism behind this finding.

Download Full-text

Weight gain in patients with severe atopic dermatitis treated with dupilumab: a cohort study

10.21203/rs.3.rs-18421/v2 ◽

2020 ◽

Author(s):

Emma Kristin Johansson ◽

Lina Ulrika Ivert ◽

Baltzar Bradley ◽

Maria Lundqvist ◽

Maria Bradley

Keyword(s):

Atopic Dermatitis ◽

Cohort Study ◽

Weight Gain ◽

Weight Change ◽

Rating Scale ◽

Interleukin 4 ◽

Rank Test ◽

Severe Atopic Dermatitis ◽

Night Sleep

Download Full-text

Weight gain in patients with severe atopic dermatitis treated with dupilumab: a cohort study

BMC Dermatology ◽

10.1186/s12895-020-00103-0 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Emma Kristin Johansson ◽

Lina Ulrika Ivert ◽

Baltzar Bradley ◽

Maria Lundqvist ◽

Maria Bradley

Keyword(s):

Atopic Dermatitis ◽

Cohort Study ◽

Weight Gain ◽

Weight Change ◽

Rating Scale ◽

Interleukin 4 ◽

Rank Test ◽

Severe Atopic Dermatitis ◽

Night Sleep

Abstract Background Dupilumab, targeting the interleukin-4α receptor and inhibiting the action of interleukin-4 and interleukin-13, was recently approved for treatment of moderate to severe atopic dermatitis. There is limited data on long-term effects and safety among patients with severe atopic dermatitis treated with dupilumab. Weight gain was observed among patients treated with dupilumab in our clinic. The aim was to describe weight change in a cohort study of patients with severe atopic dermatitis treated with dupilumab from baseline to follow-up after 12 months, and to analyze if weight change was associated with effect of treatment, reported appetite, and/or disturbed night sleep due to itching. Methods All patients with atopic dermatitis receiving systemic treatment at the Unit of Dermatology, Karolinska University Hospital, have been registered and monitored consecutively since January 2017. This cohort constituted all patients who started treatment on dupilumab or methotrexate between 10 January 2017 and 30 June 2019 with at least 6 months of follow-up within the study period. The following variables were monitored at start of and during treatment: Eczema Severity Score Index, Patient-Oriented Eczema Measure, visual analogue scale for pruritus 10 cm, Montgomery-Åsberg Depression Rating Scale, Dermatology Life Quality Index, and weight. Data analyses were performed using two-sample Wilcoxon-Mann-Whitney rank-sum test, or the Wilcoxon matched-pairs sign-rank test with a p-value < 0.05 considered as statistically significant. Results Patients treated with dupilumab (n = 12) gained weight (mean 6.1 kg, range [0.1–18.0], p = 0.002) after 1 year on treatment. The majority of patients showed a good response to treatment with dupilumab (n = 11); at follow-up at 6, 9, or 12 months, they reached EASI-90 (n = 6), EASI-75 (n = 4), or EASI-50 (n = 1). There was no significant association between weight gain and treatment response, reported appetite, or disturbed night-sleep due to itch. Patients treated with methotrexate showed no significant weight change (n = 8). Conclusions To our knowledge, this is the first report on a possible association between weight gain and dupilumab treatment; the extent of the association is yet to be seen, as is the mechanism behind this finding.

Download Full-text

Weight gain in patients with severe atopic dermatitis treated with dupilumab: a case series

10.21203/rs.3.rs-18421/v1 ◽

2020 ◽

Author(s):

Emma Kristin Johansson ◽

Lina Ulrika Ivert ◽

Baltzar Bradley ◽

Maria Lundqvist ◽

Maria Bradley

Keyword(s):

Atopic Dermatitis ◽

Weight Gain ◽

Weight Change ◽

Rating Scale ◽

Case Series ◽

Interleukin 4 ◽

Rank Test ◽

Severe Atopic Dermatitis ◽

Night Sleep

Abstract Background Dupilumab, targeting the interleukin-4α receptor and inhibiting the action of interleukin-4 and interleukin-13, was recently approved for treatment of moderate to severe atopic dermatitis. There is limited data on long-term effects and safety among patients with severe atopic dermatitis treated with dupilumab. Weight gain was observed among patients treated with dupilumab in our clinic. The aim was to describe weight change in a case series of patients with severe atopic dermatitis treated with dupilumab from baseline to follow-up after 12 months, and to analyze if weight change was associated with effect of treatment, reported appetite, and/or disturbed night sleep due to itching. Methods All patients with atopic dermatitis receiving systemic treatment at the Unit of Dermatology, Karolinska University Hospital, have been registered and monitored consecutively since January 2017. This case series constituted all patients who started treatment on dupilumab or methotrexate between 10 January 2017 and 30 June 2019 with at least 6 months of follow-up within the study period. The following variables were monitored at start of and during treatment: Eczema Severity Score Index, Patient-Oriented Eczema Measure, visual analogue scale for pruritus 10cm, Montgomery-Åsberg Depression Rating Scale, Dermatology Life Quality Index, and weight. Data analyses were performed using two-sample Wilcoxon-Mann-Whitney rank-sum test, or the Wilcoxon matched-pairs sign-rank test with a p-value <0.05 considered as statistically significant. Results Patients treated with dupilumab (n=12) gained weight (mean 6.1 kg, range [0.1–18.0], p=0.002) after one year on treatment. The majority of patients showed a good response to treatment with dupilumab (n=11); at follow-up at 6, 9, or 12 months, they reached EASI-90 (n=6), EASI-75 (n=4), or EASI-50 (n=1). There was no significant association between weight gain and treatment response, reported appetite, or disturbed night-sleep due to itch. Patients treated with methotrexate showed no significant weight change (n=8). Conclusions To our knowledge, this is the first report on a possible association between weight gain and dupilumab treatment; the extent of the association is yet to be seen, as is the mechanism behind this finding.

Download Full-text

Clinical Response and Quality of Life in Patients with Severe Atopic Dermatitis Treated with Dupilumab: A Single-Center Real-Life Experience

Journal of Clinical Medicine ◽

10.3390/jcm9030791 ◽

2020 ◽

Vol 9 (3) ◽

pp. 791 ◽

Cited By ~ 6

Author(s):

Silvia Ferrucci ◽

Giovanni Casazza ◽

Luisa Angileri ◽

Simona Tavecchio ◽

Francesca Germiniasi ◽

...

Keyword(s):

Quality Of Life ◽

Atopic Dermatitis ◽

Rating Scale ◽

Real Life ◽

Life Quality ◽

Depression Scale ◽

Interleukin 4 ◽

Severe Atopic Dermatitis ◽

Single Center

Dupilumab is an anti-interleukin-4 receptor monoclonal antibody that was recently approved for the treatment of atopic dermatitis (AD). In this single-center retrospective study, clinical baseline data of 117 severe AD patients treated with dupilumab were collected. At baseline and at weeks 4 and 16, disease severity was assessed through the Eczema Area and Severity Index (EASI) and quality of life through the Dermatology Life Quality Index (DLQI) questionnaire, Patient-Oriented Eczema Measure (POEM), Hospital Anxiety and Depression Scale (HADS), Peak Pruritus Numerical Rating Scale (NRS-itch), and VAS-sleep. Response to dupilumab was defined as an improvement of ≥75% in EASI from baseline (EASI75). At multivariate analysis, AD onset before 18 years [OR, 2.9; 95% CI, 1.2–7.2; p = 0.0207] and absence of hypereosinophilia [OR, 2.24; 95% CI, 1.03–4.86; p = 0.0412] were identified as significant predictive parameters for response to dupilumab in terms of EASI75 at week 4 but not at week 16. Significant reductions in EASI, DLQI, POEM, HADS, NRS-itch, and VAS-sleep were found between week 4 versus baseline (p < 0.0001 for all) and week 16 versus baseline (p < 0.0001 for all). Early AD onset and absence of hypereosinophilia may be suggested as predictive markers of early response to dupilumab. We confirmed the efficacy and safety of this agent along with the improvement of life quality in severe AD patients.

Download Full-text

Weight change over two years in people prescribed olanzapine, quetiapine and risperidone in UK primary care: Cohort study in THIN, a UK primary care database

Journal of Psychopharmacology ◽

10.1177/0269881118780011 ◽

2018 ◽

Vol 32 (10) ◽

pp. 1098-1103 ◽

Cited By ~ 3

Author(s):

David PJ Osborn ◽

Irene Petersen ◽

Nick Beckley ◽

Kate Walters ◽

Irwin Nazareth ◽

...

Keyword(s):

Primary Care ◽

Cohort Study ◽

Weight Gain ◽

Confidence Interval ◽

Weight Change ◽

Antipsychotic Treatment ◽

Weight Changes ◽

Baseline Weight ◽

Care Database

Background: Follow-up studies of weight gain related to antipsychotic treatment beyond a year are limited in number. We compared weight change in the three most commonly prescribed antipsychotics in a representative UK General Practice database. Method: We conducted a cohort study in United Kingdom primary care records of people newly prescribed olanzapine, quetiapine or risperidone. The primary outcome was weight in each six month period for two years after treatment initiation. Weight changes were compared using linear regression, adjusted for age, baseline weight and diagnosis. Results: N = 6338 people received olanzapine, 12,984 quetiapine and 6556 risperidone. Baseline weight was lowest for men treated with olanzapine (80.8 kg versus 83.5 kg quetiapine, 82.0 kg risperidone) and women treated with olanzapine (67.7 kg versus 71.5 kg quetiapine 68.4 kg risperidone. Weight gain occurred during treatment with all three drugs. Compared with risperidone mean weight gain was higher with olanzapine (adjusted co-efficient +1.24 kg (95% confidence interval: 0.69–1.79 kg per six months) for men and +0.77 kg (95% confidence interval: 0.29–1.24 kg) for women). Weight gain with quetiapine was lower in unadjusted models compared with risperidone, but this difference was not significant after adjustment. Conclusion: Olanzapine is more commonly prescribed to people with lower weight. However, after accounting for baseline weight, age, sex and diagnosis, olanzapine is still associated with greater weight gain over two years than risperidone or quetiapine. Baseline weight does not ameliorate the risks of weight gain associated with antipsychotic medication. Weight gain should be assertively discussed and managed for people prescribed antipsychotics, especially olanzapine.

Download Full-text

Maternal weight change from prepregnancy to 18 months postpartum and subsequent risk of hypertension and cardiovascular disease in Danish women: A cohort study

PLoS Medicine ◽

10.1371/journal.pmed.1003486 ◽

2021 ◽

Vol 18 (4) ◽

pp. e1003486

Author(s):

Helene Kirkegaard ◽

Mette Bliddal ◽

Henrik Støvring ◽

Kathleen M. Rasmussen ◽

Erica P. Gunderson ◽

...

Keyword(s):

Cardiovascular Disease ◽

Weight Loss ◽

Cohort Study ◽

Weight Gain ◽

Weight Change ◽

Postpartum Weight Retention ◽

Weight Retention ◽

Prepregnancy Bmi ◽

Postpartum Weight

Background One-fourth of women experience substantially higher weight years after childbirth. We examined weight change from prepregnancy to 18 months postpartum according to subsequent maternal risk of hypertension and cardiovascular disease (CVD). Methods and findings We conducted a cohort study of 47,966 women with a live-born singleton within the Danish National Birth Cohort (DNBC; 1997–2002). Interviews during pregnancy and 6 and 18 months postpartum provided information on height, gestational weight gain (GWG), postpartum weights, and maternal characteristics. Information on pregnancy complications, incident hypertension, and CVD was obtained from the National Patient Register. Using Cox regression, we estimated adjusted hazard ratios (HRs; 95% confidence interval [CI]) for hypertension and CVD through 16 years of follow-up. During this period, 2,011 women were diagnosed at the hospital with hypertension and 1,321 with CVD. The women were on average 32.3 years old (range 18.0–49.2) at start of follow-up, 73% had a prepregnancy BMI <25, and 27% a prepregnancy BMI ≥25. Compared with a stable weight (±1 BMI unit), weight gains from prepregnancy to 18 months postpartum of >1–2 and >2 BMI units were associated with 25% (10%–42%), P = 0.001 and 31% (14%–52%), P < 0.001 higher risks of hypertension, respectively. These risks were similar whether weight gain presented postpartum weight retention or a new gain from 6 months to 18 months postpartum and whether GWG was below, within, or above the recommendations. For CVD, findings differed according to prepregnancy BMI. In women with normal-/underweight, weight gain >2 BMI units and weight loss >1 BMI unit were associated with 48% (17%–87%), P = 0.001 and 28% (6%–55%), P = 0.01 higher risks of CVD, respectively. Further, weight loss >1 BMI unit combined with a GWG below recommended was associated with a 70% (24%–135%), P = 0.001 higher risk of CVD. No such increased risks were observed among women with overweight/obesity (interaction by prepregnancy BMI, P = 0.01, 0.03, and 0.03, respectively). The limitations of this observational study include potential confounding by prepregnancy metabolic health and self-reported maternal weights, which may lead to some misclassification. Conclusions Postpartum weight retention/new gain in all mothers and postpartum weight loss in mothers with normal-/underweight may be associated with later adverse cardiovascular health.

Download Full-text

Serum 25-hydroxyvitamin D level in relation to weight change and the risk of weight gain in adults of normal weight at baseline: the Norwegian HUNT cohort study

BMJ Open ◽

10.1136/bmjopen-2020-039192 ◽

2020 ◽

Vol 10 (9) ◽

pp. e039192

Author(s):

Adaline Heitz ◽

Xiao-Mei Mai ◽

Yue Chen ◽

Yi-Qian Sun

Keyword(s):

Cohort Study ◽

Weight Gain ◽

Weight Change ◽

Relative Weight ◽

Normal Weight ◽

Secondary Outcome ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

Reduced Risk

ObjectiveWe sought to investigate the relationship of serum 25-hydroxyvitamin D (25(OH)D) level with weight change and the risk of weight gain in an adult population who had normal weight at baseline and were followed up for 11 years.DesignA population-based prospective cohort study.SettingNord-Trøndelag, Norway.ParticipantsThe study included 1501 adults who participated in the second and third surveys of the Nord-Trøndelag Health Study (HUNT2 (1995–1997) and HUNT3 (2006–2008)) and had a normal body mass index ≥18.5 and <25.0 kg/m2 at baseline.Primary and secondary outcome measuresRelative weight change (%) was calculated as ((HUNT3 weight−HUNT2 weight)/HUNT2 weight×100). Relative annual weight change (%) was calculated as (relative weight change/follow-up years×100). Clinical weight gain was defined as relative weight change ≥5% over the 11 years, while annual weight gain was defined as relative annual weight change >1.25%.MethodsMultiple regression models were used to estimate adjusted coefficients for the relative annual weight change and risk ratios (RRs) for the risk of clinical weight gain and of annual weight gain.ResultsEach 25 nmol/L increase in season-standardised serum 25(OH)D level at baseline was associated with a reduction of 0.05% (95% CI −0.11 to 0.01) for relative annual weight change, a 10% (RR 0.90, 95% CI 0.82 to 0.97) reduced risk of clinical weight gain, and a 19% (RR 0.81, 95% CI 0.65 to 1.00) reduced risk of annual weight gain. A statistically significant trend was evident for the risk of clinical weight gain when 25(OH)D levels were treated as a categorical variable (p=0.006).ConclusionsThe findings suggested an inverse association of serum 25(OH)D level with the risk of clinical weight gain in adults who had normal weight at baseline over 11 years’ follow-up.

Download Full-text

FOLLOW-UP OF PATIENTS AND PROGNOSTIC IMPACT OF TUMOUR MARKER CA 15-3 ON PATIENTS OF BREAST CANCER: A RETROSPECTIVE COHORT STUDY

International Journal of Advanced Research ◽

10.21474/ijar01/12052 ◽

2020 ◽

Vol 8 (11) ◽

pp. 656-660

Author(s):

Anjali Vinocha ◽

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Cancer Patients ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Relative Survival ◽

Rank Test ◽

Prognostic Impact ◽

Breast Cancer Patients

Introduction:Breast cancer is the most common cancer in women, with 5- and 10-year relative survival rates are 91% and 84%, respectively for women with invasive breast cancer. This study aimed to detect the role of serum breast cancer marker CA 15-3 for early detection of metastasis, relapse or recurrence for management of breast cancer patients. Methods: It was a retrospective cohort study with a total of 132 breast cancer patients from the year 2010 to march 2020 were taken and followed up. For these patients demographic, biochemical parameters, radiological and clico-pathological data were collected and analysed. Result: The mean age at the time of presentation and mean duration of follow-up was 47 years and 31 months respectively. There was elevation in the serum level of CA 15-3 at the time of diagnosis of metastasis, recurrence or residual disease in 41 patients. This shows that sensitivity of elevated CA 15-3 (> 30 IU/ml) level in Ca Breast patients was 84%, 75 % and 75 % with respect to metastasis, recurrence and relapse. Log Rank test Chi- square value was 7.39 which was statistically significant (p=0.007). Cox proportional hazard model was created for effect of age at presentation, CA 15-3 at the time of diagnosis and MRM on distant metastasis and was statistically significant (p=0.037). Conclusion: We recommend that for the management of breast cancer patients, Cancer antigen (CA 15-3) levels can be used as prognostic marker for early diagnosis of metastasis, recurrence or relapse.

Download Full-text

Laparoscopic hepatectomy versus open hepatectomy for hepatocellular carcinoma in 158 patients: A prospective cohort study

10.21203/rs.3.rs-58070/v1 ◽

2020 ◽

Author(s):

Jiao Yuan ◽

Li Zeng ◽

min tian ◽

Sisi Chen ◽

Huai yi Yao ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Cohort Study ◽

Survival Rate ◽

Liver Cancer ◽

Laparoscopic Hepatectomy ◽

Rank Test ◽

Log Rank Test ◽

Open Hepatectomy ◽

Disease Free

Abstract BackgroundHepatocellular carcinoma (HCC) ranks as the fourth most common cancer and the third leading cause of cancer-related mortality worldwide. With the development of minimally invasive surgical techniques, laparoscopic hepatectomy is becoming more prevalent in liver surgery. There are multiple reports to evaluate the safety and feasibility of laparoscopic liver resection. Unfortunately, the jury is still out on whether laparoscopic hepatectomy is better than open hepatectomy. The aim of this study is to compare the perioperative and postoperative long-term outcomes of open hepatectomy and laparoscopic hepatectomy for hepatocellular carcinoma, and to evaluate the safety and efficacy of the two surgical methods for hepatocellular carcinoma.MethodsA prospective cohort study of patients who underwent major hepatectomy for hepatocellular carcinoma between October 2017 and September2018 was performed. And these patients were followed for 24 months after surgery. There are158 patients involved in the present study and they were randomly divided into two groups, LH group (n=60), and OH group (n=98). And all of 158 patients underwent hepatectomy. Continuous data were compared by one-way ANOVA, and categorical data were compared by Fisher’s exact test or the c2 test. Survival curves were calculated by the Kaplan–Meier method and compared using the log-rank test. The study was approved by the ethics committee of Union Hospital. (No. WHUH2018S002) and registered in the International Clinical Trial Registry (No. NCT03585166). Informed consent was signed by all patients.ResultsIncision lengths of LH (5.14±3.11cm) were shorter than OH(20.92±6.44cm), P<0.001. Operating time of LH (398.53±170.51 minutes) were longer than OH(257.74±91.31 minutes), P=0.003. Hospital stay of LH(17.72±5.82 days) were shorter than OH(21.42±8.44 days), P<0.001. The average hospitalization costs of LH group (82741.18±26128.81￥) were significantly less than OH group (94998.75±30499.64￥), p=0.011<0.05. The incidence of total complications was also lower in LH group than in OH group (P<0.001). Postoperatively, the leukocyte was significantly lower at 1st day in LH group (9.79±2.92G/L) than in OH group (12.6±4.85 G/L), p<0.001.The aspartate aminotransferase (AST) was significantly lower at 7th day in LH group (39.25±16.63 U/L) than in OH group (62.49±67.77 U/L), p=0.01<0.05. The albumin was significantly higher at 3rd day in LH group (34.21±3.94 g/L) than in OH group (31.24±5.23 g/L), p<0.001. The albumin was significantly higher at 7th day in LH group (35.26±3.73 g/L) than in OH group (33.31±4.51 g/L), p=0.006<0.05. Direct bilirubin was significantly higher at 1st day in LH group (10.28±10.70 µmol /L) than in OH group (315.03±15.71 µmol /L), p=0.04<0.05. The follow-up time after surgery was 24 months (1-24). The mean follow-up time after surgery was 17.94±9.132. Log rank test was performed to compare overall survival rates between the two groups. There were no statistically significant differences with 2-year survival rate between LH and OH group for liver cancer patients, nor was disease-free survival.ConclusionsLaparoscopic hepatectomy surgery supplied a lower incision lengths, hospital stay and incidence of total complications. Laparoscopic hepatectomy was cheaper the open hepatectomy.There were no statistically significant differences with 2-year survival rate between the two group for liver cancer patients, nor was disease-free survival.

Download Full-text

Fifty‐two week follow‐up safety and effectiveness results of dupilumab treatment of moderate‐to‐severe atopic dermatitis from a retrospective, multicentric series

Dermatologic Therapy ◽

10.1111/dth.12931 ◽

2019 ◽

pp. e12931 ◽

Cited By ~ 8

Author(s):

Ricardo Ruiz‐Villaverde ◽

Javier Dominguez‐Cruz ◽

Jose Carlos Armario‐Hita ◽

Leandro Martinez‐Pilar ◽

Sara Alcantara‐Luna ◽

...

Keyword(s):

Atopic Dermatitis ◽

Severe Atopic Dermatitis

Download Full-text