Atopic Dermatitis
Conditions
Keywords
dupilumab, pattern recognition, immune cells
Brief summary
Currently, patients with moderate to severe atopic dermatitis are treated with dupilumab if unresponsive to topical treatment. However, not all patients who suffer from atopic dermatitis respond similarly to this treatment. Pattern recognition of immune cells (PRI) is an efficient method to screen patients to allow a more personalized therapy. The main aim of this scientific explorative study is to unravel the changes in peripheral blood immune cell compositions in patients with atopic eczema undergoing dupilumab treatment. This allows the identification of phenotypes of treatment responders and non-responders and possible approaches of treatment modifications for non-responders.
Detailed description
A better understanding of the pathology of atopic dermatitis could lead to the development of new therapeutic strategies for this disease and contribute to better and more targeted disease management - an advantage for all patients with atopic dermatitis. The PRI is a new bioinformatic analysis strategy that allows in-depth data analysis from flow cytometry with multiple variables. This facilitates the identification of meaningful T cell subpopulations, which are differentially abundant between two groups to predict responders and non-responders prior to dupilumab treatment. Peripheral blood will be collected before, 4 weeks, 8 weeks, and 16 weeks after initiating the systemic treatment with dupilumab to identify recognition patterns/markers on the T cells. Therefore, a predefined multicolor flow cytometry panel was developed to analyse lineage, differentiation and activation markers. Patients will receive a systemic therapy (dupilumab 600 mg loading dose, followed by 300 mg in two weeks intervals). Follow up visits will be performed every 3 months starting from the second visit (2nd visit will take place 4 weeks after initiating Dupilumab treatment). The blood samples that are taken as part of this scientific study are pseudonymized in the research laboratories and stored for a period of 5 years after the end of this study or the publication of the results and destroyed.
Interventions
Patients undergoing systemic therapy according to international accepted guidelines for the therapy of atopic dermatitis, observational study
Sponsors
Sanofi
LEO Pharma
Charite University, Berlin, Germany
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Age 18 and above * Diagnosis of atopic dermatitis for ≥1 year * Inadequate response to treatment with topical medications * Confirmed dupilumab treatment
Exclusion criteria
* Age below 18 * Known or suspected allergy or reaction to any component of the dupilumab formulation * Known active allergic or irritant contact dermatitis that is likely to interfere with the assessment of the severity of AD * Severe conjunctivitis or blepharitis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Comparison of T-cell inflammatory markers | 1 year | Identification of at least one pattern recognition profile showing a strong association with responder status to dupilumab therapy |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Different T-cell pattern with dupilumab therapy | 1.5 years | Time in which the pattern of T-cell modulation after initiation of dupilumab therapy (measured using PRI) shows significant differences from the baseline. |
| Assign recognition patterns to clinical symptoms | 3 months | Association of recognition patterns with clinical symptoms of atopic dermatitis (measured using Cramer's V \> 0.5) with a specific interest in conjunctivitis, pruritus, asthma and herpes infections. |
| Connection of molecular profile and phenotype | 3 months | Classification and clustering of at least two molecular profiles of peripheral blood immune cells in relation to phenotypes of atopic dermatitis (Cramer's V either with association to IgE levels or early/late onset AD). |
Countries
Germany
Outcome results
None listed