Is dupilumab effective in adult‐onset atopic dermatitis: Real‐life experience of 16 patients

Abstract

Background Dupilumab is approved for the treatment of atopic dermatitis (AD). However, there are few studies demonstrating its efficacy and safety, particularly in the treatment of adult‐onset AD. Objective The aim of this study is to evaluate the real‐life experience regarding the efficacy and safety of dupilumab in the treatment of adult‐onset AD. Methods This study is a case series in retrospective design. Patients with the diagnosis of adult‐onset AD, using dupilumab at a standard dose for at least 3 months, were included in the study. Demographic and laboratory data of the cases, data regarding to dupilumab treatment, were recorded. The eczema area severity index (EASI) and the visual analog scale (VAS) for itch were used to evaluate treatment efficacy. Results A total of 16 patients, 6 female and 10 male, were included. The median age was 41 years, the median age of the disease onset was 37.5 years, and the median duration of the disease was 90 months. The median duration of the dupilumab treatment was 10.5 months. The mean percent reduction from baseline in EASI score was 85.8 ± 12.2 at 3 months, 90.7 ± 9.3 at 6 months, and 93.1 ± 5 at 12 months. The mean percent reduction from baseline in VAS itch score was 82.2 ± 8.6 at 3 months. Acute vestibular neuritis was developed in one patient during the dupilumab therapy and resolved with anti‐inflammatory therapy. Conclusion Dupilumab seems to be highly effective and safe in the treatment of adult‐onset AD. The present study is important as it is the first study to evaluate this patient group specifically.

Age of onset defines two distinct profiles of atopic dermatitis in adults

“…AOAD has a heterogeneous presentation, involving atypical forms (such as prurigo nodularis and nummular eczema) and often involves difficult-to-treat areas (e.g., hand dermatitis and head/neck). 2,58,59 While dupilumab is effective in adult AD, including in AOAD, [60][61][62][63] atypical AD forms such as prurigo nodularis-like and nummular eczema demonstrated slower responses. 63,64 Moreover, dupilumab has been reported to also induce exacerbation or de-novo onset of head/neck dermatitis.…”