TABLE 1
Overall mean results at baseline and at review
EASI score mean ( range )
DLQI score mean ( range )
Prior to therapy
29.7 ( 3 – 66.7 ) n = 29
19.0 ( 7 – 30 ) n = 30
At review
2.9 ( 0 – 27.9 ) n = 30
4.1 ( 0 – 28 ) n = 30
correspondence ( as part of the medical record ) were examined as far back as 2012 if necessary for relevant information about patients ’ treatment .
Health Research Authority criteria about research and service evaluation were considered . This was a retrospective assessment involving no changes to the service delivered to patients , and we used the NHS Health research authority tool ( www . hra-decisiontools . org . uk / research / index . html ) which helped confirm that no ethical approval was required for this project . Patient data were used in accordance with local NHS hospital policy .
Results At the time of the Blueteq extract , there were 88 patients on the Blueteq system , and the records of 30 patients were reviewed . Most entries were from when the NICE TA first approved dupilumab , though a few entries were chosen from late 2021 / early 2022
In this very small study , 28 of 30 patients were compliant with NICE criteria for commencing dupilumab in atopic dermatitis
There were 18 males and 12 females who had commenced on dupilumab and been reviewed approximately 16 weeks later ; mean age was 44 years ( range 18 – 73 ).
Twenty-six ( 87 %) patients had tried phototherapy and 26 ( 87 %) had evidence in their dermatology records of having been prescribed a course of prednisolone at some point . As regards the named prior systemic therapy ( ciclosporin , methotrexate , azathioprine , and mycophenolate ) in the NICE TA , all but one patient had been on at least one of these medicines . Four patients had tried all four therapies .
One patient , who began dupilumab at a tertiary centre , did not have a starting EASI score in our hospital records . Of the 29 patients with a baseline score , 28 ( 97 %) experienced the required 50 % or more reduction in EASI score at the review meeting , whilst 28 ( 93 %) of all 30 patients achieved the at least 4-point reduction in DLQI . One patient did not meet both NICE criteria showing only a reduction in EASI score from 33.6 to 27.9 ( and not the required 50 % reduction ) and DLQI from 30 to 28 ( and not the 4-point reduction ) , and one patient had the required reduction in EASI score from 48 to 2 but did not have the required DLQI reduction ( only a decrease from 13 to 10 and not the 4-point reduction ). Both had their treatment ceased . Table 1 shows overall results at baseline and at review .
Discussion This small-scale study found that 28 of 30 patients met all the NICE starting requirements for dupilumab treatment . The two instances of non-compliance were one patient who did not have recorded locally an EASI score , and one patient who
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