One-Year Effectiveness and Safety of Dupilumab Treatment for Moderate-to-Severe Atopic Dermatitis in Korean Patients: A Real-World Retrospective Analysis

Abstract

Dupilumab was the first biological drug to be approved for adult patients with moderate-to-severe atopic dermatitis (AD), and its use is growing exponentially worldwide. Though its therapeutic efficacy and favorable safety profile have been demonstrated, data on real-world long-term experience with the drug are only beginning to accumulate. Herein, we present a retrospective analysis of Korean patients with moderate-to-severe AD who were treated with dupilumab. We observed excellent overall treatment efficacy with the mean Eczema Area and Severity Index (EASI) score decreased from 28.2 to 3.2 at week 52. Notably, the therapeutic effect was maintained despite the considerable number of patients requiring an increase in treatment intervals due to the financial burden in a real clinical setting. In contrast to the previous reports, paradoxical head and neck erythema/dermatitis was rare in our study group, and pre-existing dermatitis in the very region, as well as in the hands, responded well to dupilumab treatment. Additionally, we were able to discontinue dupilumab treatment for two patients who achieved complete clearance of AD symptoms (EASI and Investigator's Global Assessment [IGA] scores of 0) for more than three months. There have been no flare-up events of AD in these patients; with topical corticosteroids alone, one of them has been completely disease-free for 43 weeks and the other has been maintaining an IGA score of 1 for 66 weeks. Furthermore, conjunctivitis was again confirmed to be the most frequent side effect associated with dupilumab, and it generally responded well to conventional conjunctivitis treatment.

Dupilumab Improves Clinical Scores in Pediatric Patients Aged 2 to <18 Years with Uncontrolled Atopic Dermatitis: A Single‐Center, Real‐World Study

“…Te overall incidence of treatment-emergent adverse events was 7.7% in our pediatric cohorts during the 16-week dupilumab treatment period (Table 3), which was even lower than previous real-world studies in children aged 6-11 years (12.5%), adolescents (13.5%), and adults (17.5%) [14,15,18]. In fact, a larger regimen (Table 3) was partly administrated in our cohorts, which might further prove dupilumab a safe choice in pediatric patients, considering the low occurrence of adverse events.…”

A nationwide 104 weeks real‐world study of dupilumab in adults with atopic dermatitis: Ineffectiveness in head‐and‐neck dermatitis

“…Other treatments that do not share this limitation may be considered in these patients. Improvement with dupilumab in the head‐and‐neck area has been reported in trials and in real‐world studies 25–27 . Importantly, we present patient‐reported eczema localization, which is essentially different from evaluating Investigator's Global Assessment (IGA) scores or EASI improvements in the region.…”

“…Improvement with dupilumab in the head-and-neck area has been reported in trials and in real-world studies. [25][26][27] Importantly, we present patient-reported eczema localization, which is essentially different from evaluating Investigator's Global Assessment (IGA) scores or EASI improvements in the region. Surely, eczema in the head-and-neck region can improve, but for twothird of our patients, lesions were still present at 104-week follow-up.…”

Real‐world reported adverse events related to systemic immunomodulating therapy in patients with atopic dermatitis: Results from the TREAT NL (TREatment of ATopic eczema, the Netherlands) registry

“…Ocular complaints arising during dupilumab treatment have been increasingly reported since its approval in 2017, with conjunctivitis being the most frequently described ocular AE. [33][34][35] However, studies often do not specify the type of conjunctivitis. 36 Similarly, the SmPC only mentions allergic conjunctivitis and infectious conjunctivitis.…”