Evaluation of Outcomes of Dupilumab Therapy in Patients with Atopic Dermatitis - A Single-Center Retrospective Longitudinal Study.

Background: Eczema control is a measurable construct currently recommended to be monitored for the management of atopic dermatitis (AD) in clinical trials. Aims: Measuring eczema-related outcomes with a focus on patient-perceived eczema control in AD patients over a period of 12 months during which they were treated with dupilumab. Methods: All patients with severe AD (Eczema Area and Severity Index (EASI) score ≥24) who initiated dupilumab from June 2020 to February 2022 and continued treatment for at least one year were included in this study. Monitored outcomes include EASI, Atopic Dermatitis Control Tool (ADCT), Dermatology Life Quality Index (DLQI) and peak pruritus/sleep Numerical Rating Scale (NRS). Results: Sixty-one patients were included. At 4 months of treatment, absolute cutoff score EASI ≤7 was reached by 59% of patients, ADCT ≤7 by 50.8%, DLQI ≤5 by 78.7%, itch-NRS ≤4 by 68.8% and sleep NRS ≤4 by 8.5%. At 12 months of treatment, absolute cutoff score EASI ≤7 was reached by 85.2%, ADCT ≤7 by 83.6%, DLQI ≤5 by 86.9%, itch-NRS ≤4 by 88.5% and sleep NRS ≤4 by 91.8%. Minimally clinically important difference of ≥5 ADCT points and ≥4 DLQI points were achieved, respectively, by 96.7% and 88.5% of patients at 4 months and by 100% and 96.7% at 12 months. Conclusions: This study found that treatment with dupilumab consistently achieved disease control at 12 months of therapy. At 4 months, statistically meaningful improvements relative to baseline were observed for all the patient-related outcomes even though only half of our cohort reached the treat-to-target cutoffs for EASI and ADCT.