Long-term effectiveness and safety of treatment with dupilumab in patients with atopic dermatitis: Results of the TREAT NL (TREatment of ATopic eczema, the Netherlands) registry

• Published in: Journal of the American Academy of Dermatology 2020-11, Vol.83 (5), p.1375-1384
• Main Authors: Bosma, Angela L., de Wijs, Linde E.M., Hof, Michel H., van Nieuwenhuizen, Beau R., Gerbens, Louise A.A., Middelkamp-Hup, Maritza A., Hijnen, DirkJan, Spuls, Phyllis I.
• Format: Article
• Language: English
• Subjects: Adolescent; Antibodies, Monoclonal, Humanized - adverse effects; Antibodies, Monoclonal, Humanized - therapeutic use; atopic dermatitis; atopic eczema; Child; Child, Preschool; daily practice; Dermatitis, Atopic - drug therapy; dupilumab; effectiveness; Female; Humans; Infant; Male; Netherlands; Prospective Studies; Registries; registry; routine clinical care; safety; systemic immunomodulating treatment; Time Factors; Treatment Outcome
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2020.05.128

Evidence on long-term dupilumab treatment for atopic dermatitis in daily practice is lacking. To investigate patient characteristics, treatment aspects, effectiveness, and safety of up to 84 weeks of dupilumab treatment. An observational prospective cohort study was conducted of patients with atopic dermatitis starting dupilumab in routine clinical care. Of the 221 included patients, 103 used systemic therapy at baseline. At 84 weeks, we found a change of −15.2 (SE, 1.7) for the Eczema Area and Severity Index, −16.9 (SE, 1.4) for the Patient-Oriented Eczema Measure, and −17.2 (SE, 1.6) for the Dermatology Life Quality Index. We found a trend for improvement over time for the Investigator Global Assessment and Numerical Rating Scale for pruritus. Severe (n = 79) including serious (n = 11) adverse events were observed in 69 patients. Eye complaints were most frequently reported (n = 46). Twenty-one patients adjusted the regular dosing schedule, and 14 patients discontinued treatment, mainly due to ineffectiveness (n = 7). Only adverse events of severe and serious nature were registered for feasibility reasons. Daily practice dupilumab treatment of up to 84 weeks is generally well-tolerated, apart from the reporting of eye complaints. It can be considered a long-term effective treatment for atopic dermatitis in combination with topical and initial concomitant systemic treatment, showing a sustained improvement of signs, symptoms, and quality of life.