Ann Dermatol.  2023 Feb;35(1):38-45. 10.5021/ad.22.118.

Effect of COVID-19 (SARS-CoV-2) Vaccination on Patients with Atopic Dermatitis Treated with Dupilumab: A Multicenter, Observational Study

Affiliations
  • 1Department of Dermatology, College of Medicine, Eulji University, Daejeon, Korea
  • 2Department of Dermatology, College of Medicine, Chosun University, Gwangju, Korea
  • 3Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 4Department of Dermatology, College of Medicine, Kyung Hee University, Seoul, Korea
  • 5Department of Dermatology, School of Medicine, Kyungpook National University, Daegu, Korea
  • 6Department of Dermatology, National Medical Center, Seoul, Korea

Abstract

Background
Atopic dermatitis (AD) patients usually wonder if their condition will worsen after vaccination or if they should continue with the treatment they are receiving. Considering that many patients treated with dupilumab had previously experienced severe AD symptoms 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 agentstreated as control group) with AD from six hospitals. Patients were asked about worsening pruritus and AD (5-point Likert scale) after vaccination. AD variables (eczema area and severity index [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 AD symptoms in dupilumab-treated patients were not significantly different compared with that in 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 rescue therapy; however, most were easily managed with low-dose steroids or topical agents. None of 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 was mostly mild and transient.

Keyword

Atopic dermatitis; COVID-19 vaccines; Dupilumab
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