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.

Keywords: Atopic dermatitis; Korea; biological products; dupilumab.

Figure. Evolution of mean EASI scores from baseline through week 52.

EASI, Eczema Area and Severity Index; n, number of patients with recorded EASI scores.