P65: Retrospective analysis of the safety and appropriate use of 2,3‐diphenylcyclopropenone in alopecia in a university teaching hospital

Abstract

P65 Retrospective analysis of the safety and appropriate use of 2,3-diphenylcyclopropenone in alopecia in a university teaching hospital Z. Haider and A. Abdullah University Hospital Birmingham NHS Trust and Sandwell and West Birmingham NHS Trust, Birmingham, UK Alopecia areata (AA) is a chronic inflammatory disease that predominantly affects the hair follicle. Commonly used treatments include topical and intralesional steroids. Treatment with contact immunotherapy with 2,3-diphenylcyclopropenone (DCP) can be used for patients with difficult-totreat alopecia. There is a paucity of good-quality evidence related to use of DCP as treatment for alopecia. We carried out a retrospective analysis of 55 patients undergoing DCP treatment in a university teaching hospital treated from January 2017 to January 2020. Of 55 patients, 37 (67%) were female and 18 (33%) were male. About half of the patient cohort were < 18 years of age. Mean duration of disease was 5 5 years. Ninety-three per cent of patients were given a diagnosis of AA and 7% were given a diagnosis of alopecia universalis. On average, the duration of treatment was 16 74 months. Response outcomes were categorized as ‘complete hair growth’, ‘partial regrowth’, ‘none’ and ‘not known’. Forty-seven per cent of all patients did not have a clearly recorded response to treatment. From the data where defined responses were recorded, it is clear that there was a good response to treatment. Seventy-five per cent of patients with known outcomes had a response to treatment; of these patients, complete regrowth was noted in 32% and 43% had a partial response. Twenty-five per cent of patients had no regrowth. This is in line with published data. Breakdown of the adult and paediatric patient cohorts with known response outcomes demonstrated that adults had a better response to treatment, with complete hair growth noted in 55%. Thirtysix per cent of adult patients had a partial response and the rest had no hair growth. The paediatric population results for known responses was also favourable. Complete hair growth was noted in 37 5% of the paediatric cohort; a further 37 5% had partial regrowth. Of the 55 patients audited, 20 reported side-effects. The most common side-effect reported was blistering (n = 7). Other side-effects reported included mild dermatitis, erythema, irritation, hyperpigmentation and nonspecific reactions. Overall, the use of DCP is an effective and important specialist treatment option. Favourable results were seen in our patient cohort. The limitations in this analysis were the small sample size, potential reporting bias and lack of clear documentation. A clear and strategic plan has been put in place to help improve documentation and support for the clinic with plans to review the service again. P66 Prolonged symptom control with long-term ligelizumab treatment in patients with chronic spontaneous urticaria during post-treatment follow-up W. Soong, J.A. Bernstein, G. Sussman, B. Lanier, K. Sitz, M. Maurer, A. Gim enez-Arnau, E. Hua, A. Barve, T. Severin and R. Janocha Alabama Allergy and Asthma Center, Clinical Research Center of Alabama, Birmingham, AL, USA; University of Cincinnati College of Medicine and Bernstein Clinical Research Center, Cincinnati, OH, USA; Division of Allergy and Clinical Immunology, University of Toronto, Toronto, Canada; Texas College of Osteopathic Medicine, University of North Texas, Fort Worth, TX, USA; Clinical Research Center, Little Rock Allergy and Asthma Clinic, Little Rock, AR, USA; Department of Dermatology and Allergy, Charit e – Universit€atsmedizin Berlin, Berlin, Germany; Dermatology Department, Hospital del Mar-Parc de Salut Mar, Universitat Aut onoma de Barcelona, Barcelona, Spain; Shanghai Novartis Trading Ltd, Shanghai, China; Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA; and Novartis Pharma AG, Basel, Switzerland During the core phase IIb trial, ligelizumab – a humanized monoclonal anti-IgE antibody – demonstrated greater control of symptoms than omalizumab. Here, we aimed to analyse symptom control during post-treatment follow-up in the phase IIb trial (NCT02477332) and its extension study (NCT02649218). Eligible patients with moderate-to-severe chronic spontaneous urticaria, defined by a weekly Urticaria Activity Score (UAS7) of ≥ 16, were randomized to receive ligelizumab 24, 72 or 240 mg, omalizumab 300 mg or placebo every 4 weeks (Q4W) for five injections. Following a 16-week washout period and evidence of disease activity (UAS7 ≥ 12), eligible patients entered a 12-month open-label, single-arm (ligelizumab 240 mg Q4W) extension study, with a 12-month treatment-free follow-up. Maintenance of symptom control during the follow-up period was analysed using the Kaplan–Meier method. In the core study at week 20, wellcontrolled disease activity (UAS7 ≤ 6) was achieved in more patients who received ligelizumab 72 mg and 240 mg, respectively, than those who received omalizumab (Table 1). Following the end of treatment, in those patients who achieved UAS7 ≤ 6 at week 20, the median duration of well-controlled symptom activity was, respectively, 8 0 and 16 0 weeks with ligelizumab 72 mg and 240 mg vs. 8 0 weeks for omalizumab. In the extension study at week 52, well-controlled disease activity (UAS7 ≤ 6) was achieved in 61 1% (n = 138/ 226) of patients (ligelizumab 240 mg Q4W). After the end of treatment, the median duration of well-controlled disease activity was 28 0 weeks. After the end of treatment in the core study, treatment with ligelizumab 240 mg achieved longer maintenance of symptom control vs. the other treatment groups. Furthermore, longer-term treatment with ligelizumab 240 mg in the extension study achieved an even greater duration of symptom control than with the core study.