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Dupilumab ( Dupixent ) is the first biologic available to treat atopic dermatitis. Its effectiveness and safety were demonstrated in clinical trials.

Researchers sought to assess the effectiveness and safety of Dupilumab in adults with atopic dermatitis in a real-life French multicenter retrospective cohort.

Patients treated during March 2017-April 2018 were included.

Efficacy outcomes, including Scoring Atopic Dermatitis ( SCORAD ) and Eczema Area and Severity Index ( EASI ) scores, were collected at baseline and 3 months when available.
Adverse events were recorded at follow-up.

A total of 241 patients was included. The median ± interquartile range ( IQR ) follow-up time was 3.8 ± 3.7 months.

A greater than or equal to 75% improvement in SCORAD was achieved in 27 of 163 ( 16.6% ) patients, and a greater than or equal to 75% improvement in EASI was achieved in 40 of 82 ( 48.8% ) patients.

The median SCORAD and EASI scores at 3 months were significantly lower than those at baseline ( SCORAD ± IQR, 25 ± 21 vs 56 ± 27.4, P less than 10-9 and EASI ± IQR, 4.1 ± 6.8 vs 17.9 ± 15.4, P less than 10-9, respectively ).

Conjunctivitis was reported in 84 of 241 ( 38.2% ) patients. The proportion with eosinophilia ( more than 500 cells/mm3 ) during follow-up ( 57% ) was higher than that at baseline ( 33.7% ) ( n = 172, P less than 10-6 ).

Dupilumab was stopped in 42 cases; 27 patients stopped because of adverse effects.

In conclusion, this real-life study has demonstrated a similar Dupilumab effectiveness as that seen in clinical trials, but it also revealed a higher frequency of conjunctivitis and eosinophilia. ( Xagena )

Faiz S et al, J Am Acad Dermatol 2019; 81:143-151

XagenaMedicine2019