Real-world experience of dupilumab treatment for atopic dermatitis in adults: a retrospective analysis of patients' records

Int J Dermatol. 2020 Feb;59(2):253-256. doi: 10.1111/ijd.14573. Epub 2019 Jul 8.

Abstract

Background: Clinical trial data for dupilumab, a monoclonal antibody against the interleukin-4 receptor (IL-4Rα), have shown that it is safe and effective for the treatment of moderate to severe atopic dermatitis in patients whose disease is resistant to other therapies. However, little real-world experience with dupilumab use has been reported thus far. The aim of this retrospective study was to assess overall outcomes in adult patients with atopic dermatitis (AD) treated with dupilumab.

Methods: A retrospective review of electronic medical records was conducted for patients treated with dupilumab in the Department of Dermatology at the University of California, Irvine.

Results: We analyzed the medical records of 77 AD patients who received dupilumab according to standard dosing and had at least one documented follow-up visit. In 66 patients (86%), dupilumab improved clinical disease severity, with 23 patients (30%) experiencing complete clearance on dupilumab. Dupilumab was generally well-tolerated and caused no serious adverse events. The most common side effects included dry eyes, conjunctivitis, and keratitis. The most common reason for discontinuation of treatment was lack of substantial clinical improvement or progression of disease severity, followed by ophthalmologic side effects.

Conclusions: Overall, dupilumab was well-tolerated and resulted in clinical improvement in our patient population. These results provide additional important information on the safety and utility of dupilumab treatment for moderate to severe atopic dermatitis in the real-world clinical setting.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Boron Compounds / therapeutic use
  • Bridged Bicyclo Compounds, Heterocyclic / therapeutic use
  • Calcineurin Inhibitors / therapeutic use
  • Combined Modality Therapy
  • Conjunctivitis / chemically induced
  • Dermatitis, Atopic / drug therapy*
  • Dermatitis, Atopic / radiotherapy
  • Dermatologic Agents / adverse effects
  • Dermatologic Agents / therapeutic use*
  • Disease Progression
  • Drug Therapy, Combination
  • Dry Eye Syndromes / chemically induced
  • Female
  • Humans
  • Keratitis / chemically induced
  • Male
  • Middle Aged
  • Retrospective Studies
  • Severity of Illness Index
  • Treatment Outcome
  • Ultraviolet Therapy

Substances

  • Adrenal Cortex Hormones
  • Antibodies, Monoclonal, Humanized
  • Boron Compounds
  • Bridged Bicyclo Compounds, Heterocyclic
  • Calcineurin Inhibitors
  • Dermatologic Agents
  • dupilumab
  • crisaborole