Comparison of safety profile in patients with atopic dermatitis treated with dupilumab or conventional systemic treatment: real world data from the US network

• Published in: The Journal of dermatological treatment 2024-12, Vol.35 (1), p.2421429
• Main Authors: Zirpel, Henner, Ludwig, Ralf J, Olbrich, Henning, Kridin, Khalaf, Ständer, Sascha, Thaçi, Diamant
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Antibodies, Monoclonal, Humanized - adverse effects; Atopic dermatitis; Azathioprine - adverse effects; Azathioprine - therapeutic use; comorbidities; conventional systemic therapy; Cyclosporine - adverse effects; Cyclosporine - therapeutic use; Dermatitis, Atopic - drug therapy; Dermatologic Agents - adverse effects; Dermatologic Agents - therapeutic use; dupilumab; Female; Glucocorticoids - administration & dosage; Glucocorticoids - adverse effects; Glucocorticoids - therapeutic use; Humans; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - therapeutic use; Male; Methotrexate - adverse effects; Methotrexate - therapeutic use; Middle Aged; Mycophenolic Acid - adverse effects; risk; safety; Severity of Illness Index; Treatment Outcome; United States; Young Adult
• ISSN: 0954-6634; 1471-1753; 1471-1753
• DOI: 10.1080/09546634.2024.2421429

Safety of dupilumab in atopic dermatitis (AD) was investigated in randomized controlled trials (RCT). However, head-to-head trials comparing with conventional systemic drugs are lacking and large real-world data on the long-term safety profile as compared are scarce. To compare long-term safety profile of dupilumab with conventional systemic drugs used in the management of moderate to severe AD. Data from electronic health records of AD patients treated with either dupilumab, azathioprine, Cyclosporine A, mycophenolate mofetil, methotrexate, or oral glucocorticoids were retrieved from the TriNetX . Risks of adverse events and new onset of type-2-inflammatory diseases within 5 years after treatment initiation was investigated. 5 propensity-matched cohorts, up to 18,708 individuals per cohort, were created. Dupilumab treatment displayed reduced risk for diseases of the circulatory, the upper respiratory, and the musculoskeletal system, infections, and type 2 diseases as compared to all other treatment options. In contrast risk for conjunctivitis was increased in dupilumab treated patients as compared to mycophenolate mofetil and methotrexate. Here presented data indicates that treatment with dupilumab for AD has reduced risk for adverse effects of conventional systemic drugs and thus might be safer. Obtained data should be verified in prospective studies.