New research has provided evidence of benefit from a long-term strategy of dupilumab for the treatment of atopic dermatitis (AD).
Researchers for the multicenter cohort study looked at clinical effectiveness, response times, and reasons for discontinuation of dupilumab treatment over a period of up to five years. Researchers used the BioDay registry in the Netherlands, including data on 1,286 patients from 14 hospitals (which included children, adults, and older adults treated between October 2017 and December 2022). For evaluation, he researchers used the Eczema Area and Severity Index (EASI), Investigator Global Assessment (IGA), and numeric rating scale (NRS) for pruritus.
According to the study results, most patients maintained controlled AD, with EASI scores of 7 or lower and NRS for pruritus of 4 or lower, observed in 78.6% to 92.3% and 72.2% to 88.2% of patients, respectively. After 5 years, mean EASI was 2.7 and mean NRS for pruritus was 3.5. Around 70.5% of patients were able to extend their dosing interval to every 3 or 4 weeks.
The study team also reported that thymus- and activation-related chemokine levels significantly decreased from 1,751 pg/mL to 390 pg/mL following 6 months of treatment, which remained low. Eosinophil levels increased until week 16 and then decreased significantly over time. A total of 306 patients (23.8%) discontinued dupilumab (7.6% due to adverse events and 6.6% due to ineffectiveness). Among these, 41 patients (3.2%) restarted treatment and the majority experienced a recaptured response.
"In this cohort study with up to 5 years of follow-up, dupilumab maintained its clinical effectiveness, while two-thirds of patients tapered to a dosing interval of every 3 or 4 weeks," the researchers concluded. "Treatment was discontinued in 23.8% of patients mainly due to adverse events and/or ineffectiveness."
Source: Boesjes C, et al. JAMA Dermatology. 2024. Doi:10.1001/jamadermatol.2024.2517