Early Clinical Efficacy After Dupilumab Therapy for Adult Severe Atopic Dermatitis in a Real-World Setting

Although severe atopic dermatitis (SAD) represent less than 20% of all patients with atopic dermatitis, in this subgroup of subjects quality of life is markedly disturbed. As real-world data concerning dupilumab in patients with SAD are currently scarce, we investigated the early effect of dupilumab in a selected SAD cohort in a real-world background. Only adult patients with SAD were included. Patient demographics, medical history including comorbidities and medication use were recorded. Eczema Area and Severity Index (EASI), Scoring AD (SCORAD), validated Global Assessment scale for Atopic Dermatitis (vIGA-AD), Pruritus Numerical Rating Scale (PNRS) -prior to starting dupilumab-, atopic status (total serum IgE, skin prick test/ImmunoCAP assay, blood eosinophil level) were noted. Outcome data were collected at 4-weeks post-commencement of dupilumab (cumulative dose of 1,200 mg) including changes in clinical scores and medication use. All 7 patients (mean age 27±16.81 y.o.) reported significant (p<0.005) improvements in the median scores at the 4-week (t4) follow-up: EASI 63.81 (60-70) at baseline (t0) to 7 (1.1-8.8) at t4; t0 SCORAD 85 (63.9-96.4) to 26.9(11.9-37) at t4; t0 vIGA-AD from 4 to 1 at t4, and a reduction in PNRS from 8 to 1 at t4. All patients could effectively reduce their concomitant daily medication for SAD. No adverse events were recorded for dupilumab over the study period. Dupilumab therapy effectively resulted in prompt and significant differences in clinical outcomes in patients with SAD under real-world conditions. Further studies of dupilumab will help determine the clinical efficacy and safety profile of its long-term use.