Abstract
Introduction: Atopic dermatitis (AD) is a common, chronic, pruritic immune-mediated inflammatory dermatosis. Dupilumab is a fully human IgG4 monoclonal antibody against the interleukin (IL)-4 receptor α (IL-4Rα) subunit and has been recently approved in the United States and Europe for the treatment of adult patients with moderate-to-severe AD available in Spain since 2020. Objective: To evaluate real-world data on the efficacy and safety of dupilumab in atopic dermatitis. Material and methods: This is an observational, real practice study, conducted since Jan 2020 to August 2021. Patients fulfilled all the following criteria: Moderate to severe AD >16 years old Eczema Area and Severity Index (EASI) ≥21 Physician global assessment (PGA) ≥3 body surface area ≥10% and failure to respond both topical treatment and cyclosporine. Results: Fourteen patients (8 males) were included; mean age was 30.5 (16-57); mean basal EASI was 31.4 + 8.3. After 16 weeks of treatment, mean EASI was 6.4 + 3.5, with a mean improvement of 76.3%. An improvement of 50% in EASI was observed in 100% of the patients, EASI 75% in 64%, and EASI 90% in 21% of them. After 24 weeks of dupilumab treatment the mean EASI improvement was 89.6%, patients achieving at least an EASI improvement of 50%, 75% and 90% were 100%, 100%, and 60% respectively. A rapid mean pruritus reduction was also observed. Conjunctivitis (14%) and facial erythema (14%) were the most common adverse effects observed. Limitations. This is a small monocentric observational study with different evaluators measuring scores.
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