The efficacy of dupilumab for the treatment of atopic dermatitis (AD) found support in study data published in JAMA Dermatology. In a cohort study of patients with AD, self-reported disease control and quality of life were significantly improved at 12 months after dupilumab initiation.
The RELIEVE-AD study was a prospective, longitudinal cohort study which enrolled adults with AD from clinics throughout the United States. Data were collected from 2018 to 2020. Eligible patients completed online questionnaires at baseline and 1, 2, 3, 6, 9 and 12 months after dupilumab initiation. The questionnaires captured disease control using the Atopic Dermatitis Control Tool (ADCT). Patients were also asked to report their satisfaction with dupilumab treatment on a 7-point Likert scale. Sociodemographic and clinical characteristics were collected at baseline, including previous and concurrent treatment exposure. Disease control measures were compared between baseline and each follow-up timepoint.
A total of 699 patients initiated dupilumab, of whom 90.4% and 69.1% completed the follow-up survey at months 1 and 12, respectively. Among patients who completed the 12-month survey, mean age was 47.1 ± 15.2 years; 61.3% were women; 73.3% were White.
Mean total ACDT score at baseline was 15.8 ± 5.4, which was reduced to 6.4 ± 5.0 at month 1 (P <.001). Further reductions relative to baseline were observed at each follow-up timepoint; at month 12, the mean score was 4.4 ± 4.9 (P <.001). The percentage of patients with adequate disease control (ADCT <7) increased from 5.9% at baseline to 77.4% at month 12 (P <.001).
Patient satisfaction with treatment was low at baseline (17.7%) but increased to 85.1% by month 12.
The most common reasons for dupilumab discontinuation were adverse events, lack of efficacy, and cost/insurance issues. Use of additional therapies, including topical and systemic corticosteroids, significantly decreased each month.
During follow-up, patients consistently reported improvements in sleep duration and quality, health-related quality of life, and daily activities compared with baseline. Results were consistent with primary analyses after multiple imputation for missing data.
These data suggest to the investigators that dupilumab is an adequate means of controlling disease in patients with AD. Symptom reduction began at month 1 after initiation and continued during 12 months of follow-up. The majority of patients were highly satisfied with dupilumab treatment. As study limitations, investigators cited the absence of a control group; further study may be necessary to better explore the long-term efficacy of dupilumab.
“[Our] results are consistent with those observed in clinical trials and expand on the sustained benefits that may be expected with dupilumab over the course of long-term treatment,” investigators wrote.
Disclosure: This research was supported Sanofi and Regeneron Pharmaceuticals, Inc. Please see the original reference for a full list of disclosures
Strober B, Mallya UG, Yang M, et al. Treatment outcomes associated with dupilumab use in patients with atopic dermatitis: 1-year results from the RELIEVE-AD study. JAMA Dermatol. Published online December 15, 2021. doi:10.1001/jamadermatol.2021.4778