RF-Longer Dupilumab Dosing Intervals in Atopic Dermatitis: Optimization or Therapeutic Failure?

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(A) Psoriatic erythroderma. (B) CT scan shows an abscess in the iliac muscle." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Taibo, N. Martínez Campayo, S. Paradela, E. Fonseca" "autores" => array:4 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Taibo" ] 1 => array:2 [ "nombre" => "N." "apellidos" => "Martínez Campayo" ] 2 => array:2 [ "nombre" => "S." "apellidos" => "Paradela" ] 3 => array:2 [ "nombre" => "E." 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"apellidos" => "Rodríguez-Serna" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731024001479?idApp=UINPBA000044" "url" => "/00017310/0000011500000008/v1_202409020432/S0001731024001479/v1_202409020432/es/main.assets" ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Foro de Residentes" "titulo" => " RF-Longer Dupilumab Dosing Intervals in Atopic Dermatitis: Optimization or Therapeutic Failure?" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "T825" "paginaFinal" => "T827" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M.A. Lasheras-Pérez, F. Navarro-Blanco, M. Rodríguez-Serna" "autores" => array:3 [ 0 => array:4 [ "nombre" => "M.A." "apellidos" => "Lasheras-Pérez" "email" => array:1 [ 0 => "drmalp97@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Navarro-Blanco" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Rodríguez-Serna" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología y Venereología, Hospital Universitario y Politécnico la Fe, Valencia, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "FR-Espaciamiento de la dosis de dupilumab en dermatitis atópica: ¿optimización o fracaso terapéutico?" ] ] "textoCompleto" => "Dupilumab is a human IgG4 monoclonal antibody that targets the interleukin 4 receptor alpha (IL-4Rα), which inhibits IL-4 and IL-13. It has been approved to treat moderate-to-severe atopic dermatitis (AD), moderate-to-severe asthma, chronic rhinosinusitis with nasal polyposis, eosinophilic esophagitis, and prurigo nodularis. Regarding AD, the regimen for adults is a loading dose of 600mg, followed by 300mg every 2 weeks (Q2W).The therapeutic optimization of biological drugs consists of down-titration in patients with a sustained good response, without loss of efficacy. This practice is rooted in psoriasis and some rheumatologic diseases to avoid unnecessary overtreatment, reduce side effects, and improve economic efficiency.<a class="elsevierStyleCrossRefs" href="#bib0030">1,2</a> Below we’ll be discussing the results of 5 studies of patients with well-controlled AD on dupilumab, in whom the dosing interval was extended beyond the above-mentioned 2-week threshold.The first study to explore this idea was the randomized LIBERTY AD SOLO-CONTINUE clinical trial, which is a continuation of the trials that led to the approval of dupilumab for the management of AD. It studied a total of 422 patients categorized into 4 groups based on the dosing interval: Q1W/Q2W, Q4W, and Q8W. Thirty-six weeks after down-titration, no significant differences were reported in the percentage change observed in the Eczema Area and Severity Index (EASI), or in the proportion of patients with Investigator Global Assessment (IGA) 0-1 between the Q1W/Q2W and Q4W groups. Conversely, a proportion of patients with EASI-75 was lost (p=0.045), and the number of patients with, at least, a 3-point increase in the pruritus numeric rating scale (P-NRS) (p=0.02) increased. The Q8W group significantly reduced efficacy in the above-mentioned scales.<a class="elsevierStyleCrossRef" href="#bib0040">3</a>Afterwards, a Dutch cohort of 90 patients compared the EASI of the Q2W regimen vs the Q4W and Q6W/Q8W regimens. Down-titration was gradual, first to Q3W, and then for those who maintained responses doses were further spaced out. After an, at least, 6-month follow-up, no significant EASI increases were seen in either Q4W or Q6W/Q8W. While the P-NRS remained stable in the Q4W group, it increased in the Q6W/Q8W group (p=0.01). Despite the reduced drug levels, the severity biomarkers PARC/CCL18 and TARC/CCL17 remained low.<a class="elsevierStyleCrossRef" href="#bib0030">1</a>A French series of 88 patients identified 3 predictors of sustained response after dose reduction: spacing due to good sustained response rather than side effects (p=0.034), older age (p=0.006), and lower monthly dose of topical corticosteroids (0.016). Data from the reviewed studies are summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.<a class="elsevierStyleCrossRef" href="#bib0045">4</a><elsevierMultimedia ident="tbl0005"></elsevierMultimedia>In conclusion, various authors propose a consensual and gradual down-titration of dupilumab in well-controlled patients. It has been hypothesized that the sustained response is due to the selection of super responders, in whom a lower drug level saturates the pharmacological target.<a class="elsevierStyleCrossRefs" href="#bib0030">1,2,4,5</a> Conducting controlled studies aims to avoid iatrogenesis and promote efficiency with the advent of new drugs." "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1868517" "palabras" => array:6 [ 0 => "Dupilumab" 1 => "Atopic dermatitis" 2 => "Dose reduction" 3 => "Therapeutic optimization" 4 => "Adult" 5 => "Efficiency" ] ] ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "All significant changes were due to loss of efficacy in some scale." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Study type \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Inclusion criteria \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Primary measurement<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Regimen \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No. of Patients \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Element for statistical comparison \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Result \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">References \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Randomized clinical trial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">> 18 years, 16 weeks Q1W/Q2W DUPI 300, EASI-75 IGA 0-1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">% change in EASINo. of patients with EASI-75 after 36 weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Q1/2W Q4W Q8W Placebo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">169 86 84 83n=442 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">%EASI-0.06, EASI-75 71, 6%%EASI and EASI-75 of the Q1/2W regimen \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">%EASI-0.06, EASI-75 71.6% vs %EASI-0.06, EASI-75 71.6%, %EASI-3.84 (NS), EASI-75 58.3% (p=0.04), %EASI-6.84 (p=0.02), EASI-75 54.9% (p=0.01), %EASI-21.6 (p <0.001), EASI-75 30.4% (p <0.001) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRef" href="#bib0040">3</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prospective cohort \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">>18 years, 52 weeks Q2W with DUPI 300, EASI <7 for 6 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">EASI and P-NRS after 6 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Q2W Q4W Q8W \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 30 30n=90 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">EASI 6.4, P-NRS 4.0 vs EASI 1.7, P-NRS 2.0, EASI 2.3, P-NRS 2.0 EASI and P-NRS reached by every group before down-titration \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">EASI 5.4 (NS), P-NRS 4.0 (NS), EASI 1.5 (NS), P-NRS 2.0 (NS), EASI 2.9 (NS), P-NRS 3.0 (p <0.01) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRef" href="#bib0030">1</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Case series \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">>18 years, SCORAD50, down-titration \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Response persistence (unspecified scale) after 6.3 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Q2W Q4W \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">N=55<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Data not provided in the original article \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">At the 6.3-month follow-up, 35 individuals maintained/increased spacing. Data not provided by the lead author \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRef" href="#bib0045">4</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Case series \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">>18 years, 52 weeks Q2W with DUPI 300, EASI≤ 7 and DLQI≤ 5 for 6 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">EASI, P-NRS, DLQI after 32 weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Q3W Q4W \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35 9n=44<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">EASI 0.39, P-NRS 1.04, DLQI 3.28 vs EASI 0.18, P-NRS 1.05, DLQI 3.55EASI, P-NRS and DLQI reached by every group before down-titration \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">EASI 0.45 (NS), P-NRS 0.94 (NS), DLQI 3.2 (NS), EASI 0.22 (NS), P-NRS 1.14 (NS), DLQI 2.8 (NS) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRef" href="#bib0035">2</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Case series \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">>18 years, 52 weeks Q2W with DUPI 300, IGA 0-1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">EASI and IGA after 12 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Q3W Q4W Q2W<a class="elsevierStyleCrossRef" href="#tblfn0015">c</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">n=17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">IGA 1.00, EASI -16.05 IGA and EASI reached by every group before down-titration \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">IGA 1.42 (NS), EASI-20,10 (NS)Data not broken down by groups \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRef" href="#bib0050">5</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3637937.png" ] ] ] "notaPie" => array:3 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "When multiple measurements were available, the most recent one was used, except in <a class="elsevierStyleCrossRef" href="#bib0045">4</a> where only the described data was available." ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "Patients who increased the dose interval due to side effects were not included in this table." ] 2 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "c" "nota" => "Dose was down-titrated to 200mg of dupilumab every 2 weeks. DLQI, Dermatology Life Quality Index; DUPI, dupilumab; EASI, Eczema Area and Severity Index; IGA, Investigator Global Assessment; NS, not significant; P-NRS, Pruritus Numeric Rating scale; QXW, every “X” No. of weeks." ] ] ] "descripcion" => array:1 [ "en" => "Studies in which the dupilumab dose was spaced out due to sustained good response." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Patient-centered dupilumab dosing regimen leads to successful dose reduction in persistently controlled atopic dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L.S. Spekhorst" 1 => "D. Bakker" 2 => "J. Drylewicz" 3 => "T. Rispens" 4 => "F. Loeff" 5 => "C.M. Boesjes" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/all.15439" "Revista" => array:6 [ "tituloSerie" => "Allergy." "fecha" => "2022" "volumen" => "77" "paginaInicial" => "3398" "paginaFinal" => "3407" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35837880" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dupilumab dose spacing after initial successful treatment or adverse events in adult patients with atopic dermatitis: A retrospective analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C. Patruno" 1 => "L. Potestio" 2 => "G. Fabbrocini" 3 => "M. Napolitano" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/dth.15933" "Revista" => array:3 [ "tituloSerie" => "Dermatol Ther." "fecha" => "2022" "volumen" => "35" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy and Safety of Multiple Dupilumab Dose Regimens After Initial Successful Treatment in Patients With Atopic Dermatitis: A Randomized Clinical Trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Worm" 1 => "E.L. Simpson" 2 => "D. Thaçi" 3 => "R. Bissonnette" 4 => "J.P. Lacour" 5 => "S. Beissert" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jamadermatol.2019.3617" "Revista" => array:5 [ "tituloSerie" => "JAMA Dermatol." "fecha" => "2020" "volumen" => "56" "paginaInicial" => "131" "paginaFinal" => "143" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Longer dupilumab dosing intervals in adult patients with atopic dermatitis: experience from a French multicentre retrospective cohort study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Jendoubi" 1 => "J. Shourik" 2 => "J. Seneschal" 3 => "F. Giordano-Labadie" 4 => "N. Raison-Peyron" 5 => "A. Du-Thanh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/bjd.21628" "Revista" => array:5 [ "tituloSerie" => "Br J Dermatol." "fecha" => "2022" "volumen" => "187" "paginaInicial" => "602" "paginaFinal" => "603" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Successful Dose Reduction of Dupilumab in Atopic Dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.R. Ardern-Jones" 1 => "E.E. Buchanan" 2 => "S. Njungu" 3 => "D. O’Driscoll" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/bjd/ljad011" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol." "fecha" => "2023" "volumen" => "188" "paginaInicial" => "678" "paginaFinal" => "679" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/36662536" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/00017310/0000011500000008/v1_202409020432/S0001731024005805/v1_202409020432/en/main.assets" "Apartado" => array:4 [ "identificador" => "34907" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Foro de Residentes" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/00017310/0000011500000008/v1_202409020432/S0001731024005805/v1_202409020432/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731024005805?idApp=UINPBA000044"]