Dupilumab persistence in adult patients with atopic dermatitis is 91.9% at 6 months and 77.3% at 12 months, according to study data published in the Annals of Allergy, Asthma, and Immunology. Dupilumab persistence at 12 months was high, suggesting patient satisfaction with effectiveness, tolerability, and treatment regimen, the researchers wrote.
The retrospective cohort study searched a database to identify adults with atopic dermatitis who initiated dupilumab use from March 28, 2017, through March 31, 2018. All patients were followed until September 30, 2018, or disenrollment. The researchers used 12 months of continuous pre-index enrollment data to characterize baseline treatment history and comorbidities and the Kaplan-Meier method to estimate dupilumab persistence at 6 and 12 months, assuming a 14-day injection frequency and 30-day grace period.
A total of 1963 adults were included in the analysis (mean [SD] age, 42.1 [15.7] years; 50.7% female; 49.8% with ≥1 atopic comorbidity). Topical corticosteroids (81.6%), systemic corticosteroids (72.5%), and systemic immunosuppressants (22.8%) were among the baseline atopic dermatitis treatments prescribed.
According to the investigators, dupilumab persistence (95% confidence interval [CI]) at 6 and 12 months was 91.9% (90.7%, 93.2%) and 77.3% (75.0%, 79.7%), respectively. The risk for re-initiation was 78.8% (95% CI: 75.8%, 81.7%) within an average of 4 months in the 329 patients who discontinued dupilumab.
“These results were comparable when the length of the grace period was extended to 45 days,” the researchers commented. “Persistence at 12 months was 83.2%. A 30-day grace period represents a conservative approach to estimating persistence.”
The investigators noted study limitations, including the potential for misclassification of patients in claims-based analyses that rely on ICD diagnostic codes for population identification. In addition, the study population included only early initiators of dupilumab, which likely reflects more severe patients.
“The results from this real-world study of adults with atopic dermatitis demonstrate that those who initiated dupilumab therapy had a high prevalence of atopic comorbidities and past year use of systemic corticosteroids, immunosuppressants, and non-AD medications,” stated the study authors. “Persistence with dupilumab therapy was high, and among the few patients who discontinued, more than three quarters re-initiated treatment within 4 months.”
Disclosures: Several authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of disclosures.
Silverberg JI, Guttman-Yassky E, Gadkari A, et al. Real-world persistence with dupilumab among adults with atopic dermatitis [published online July 30, 2020]. Ann Allergy Asthma Immunol. doi: 10.1016/j.anai.2020.07.026