Long-Term Efficacy and Safety of Dupilumab in Patients with Atopic Dermatitis: A Single-Centre Retrospective Study

Abstract

Introduction: There are few long-term effectiveness and safety data for dupilumab in the treatment of atopic dermatitis (AD). The aim of this study was to evaluate efficacy and safety of dupilumab for up to three years after treatment initiation. Materials and Methods: We collected data from patients ≥ 12 years with severe AD who started dupilumab at the Dermatology Clinic of the Turin University Hospital between December 2018 and October 2022. Clinic and patient reported outcomes were evaluated from baseline, up to 3 years (T9), every 4 months. Results: A total of 418 patients were observed. A progressive decrease in the meanEASI was observed: from 23.64 at baseline to 2.31 at T9. Similar trends were observed in patients’ reported outcomes. The achievement of EASI75 and EASI90 was observed in 75.58% of patients and 53.49%, respectively, at T1 (4 months), and in 92.55% and 80.85% at T9; DLQI 0/1 was achieved at T9 in 61.7%. Mean NRSpp ≤ 4 was achieved at T9 in 91.5% (86 out of 94 patients). The most common adverse event was conjunctivitis occurring in 13% of patients on average at each timepoint analyzed. Conclusions: Dupilumab proved to be effective and safe for the treatment of AD in clinical practice, up to 3 years.

Assessment of Patient-Reported Outcomes at 48 Months of Treatment with Dupilumab for Severe Atopic Dermatitis: A Single-Center Real-Life Experience with 126 Patients

“…Regarding real-life studies, in comparison to the findings of Ortoncelli et al [17], Pruritus and Sleep NRS scores in this study demonstrate superiority at T4, T12, and T24, although it is important to note that the authors had a higher baseline Pruritus NRS. However, at T36 (3 years of treatment), the scores become comparable.…”

“…After T12, there was further progressive improvement until T48, where the median improvement reached 92.2 (76.4-100.0) (Figure 7). The percentage of patients with an extremely large effect (21-30 points) and a very large effect (11)(12)(13)(14)(15)(16)(17)(18)(19)(20) on the quality of life rapidly decreased from 20.6% and 58.0% at the baseline to 0.8% and 15.1% at T1. At T12, 0.0% and 4.0%, respectively, belonged to these two groups.…”

“…ADCT was classified as follows: 0-7 (under control) and ≥7 points (not in control) [23]. DLQI was classified as follows: no effect on the patient's life (0-1 points), small effect (2-5 points), moderate effect (6-10 points), very large effect (11)(12)(13)(14)(15)(16)(17)(18)(19)(20), and extremely large effect (21-30 points) [24]. We considered the data collected at the baseline (T0), after one month of treatment (T1), after 4 months of treatment (T4), and then every 4 months till 48 months (T48) of treatment.…”

“…To date, there is limited information on patient-reported outcomes (PROs) during real-life treatment with dupilumab. Real-life studies on PROs during long-term dupilumab treatment are scarce, although existing data indicate positive long-term outcomes related to itch, quality of life, and disease control [ 17 , 18 ].…”