A Literature Review of Real-World Effectiveness and Safety of Dupilumab for Atopic Dermatitis

Abstract

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Improvement of dupilumab‐associated conjunctivitis after switching to upadacitinib in a patient with atopic dermatitis

“…2 Conjunctivitis was observed in 8.6%-22.1% of patients during dupilumab therapy in AD clinical trials, whereas it was even more prevalent, up to 62%, in real-world reports. 1 However, in most cases, conjunctivitis was mild-to-moderate and transient. 2,3 In fact, only 2 of 2629 patients discontinued dupilumab because of ocular adverse events.…”

“…Dupilumab is an antibody against the interleukin (IL)-4R alpha subunit and blocks the signaling of IL-4 and IL-13. 1 It is approved for AD, bronchial asthma, and chronic sinusitis with nasal polyps in Japan.…”

Dupilumab nonresponders in atopic dermatitis

“…There are phase 3 studies and real-world data that have shown dupilumab is effective in most patients with AD, with a relatively safe profile. In a review of real-world data, 1 the percentage of patients with AD who achieved EASI75 (ie, an improvement in eczema severity by 75% based on Eczema Area and Severity Index) is approximately 70% over a period of 40 weeks. This is consistent with the 65% efficacy rate in the 52-week Liberty AD Chronos phase 3 trial, in which topical corticosteroids (TCS) were allowed.…”

“…2 However, although most patients have a satisfactory response to dupilumab, it is believed that a considerable number of patients have failed to respond to dupilumab in the real world. 1 The questions are, what percentage of AD patients have an inadequate response to dupilumab, and is there a way to predict them?…”

“…The prevalence of these factors in the real world likely varies depending on the population and regions. 1 The Liberty AD Chronos study, however, provides a glimpse of a probable inadequate response to dupilumab. Based on EASI50, 80% of the subjects achieved treatment success, but that also means 20% of subjects did not improve more than 50% from their baseline severity.…”