Long-term Effectiveness and Safety of Treatment With Dupilumab in Patients With Atopic Dermatitis: Results of the TREAT NL (TREatment of ATopic Eczema, the Netherlands) Registry

J Am Acad Dermatol. 2020 May 30;S0190-9622(20)31004-5. doi: 10.1016/j.jaad.2020.05.128. Online ahead of print.


Background: Evidence on long-term dupilumab treatment for atopic dermatitis in daily practice is lacking.

Objective: To investigate patient characteristics, treatment aspects, effectiveness and safety of up to 84 weeks of dupilumab treatment.

Methods: An observational prospective cohort study was conducted, including atopic dermatitis patients starting dupilumab in routine clinical care.

Results: Of the 221 included patients, 103 used systemic therapy at baseline. At 84 weeks we found a change of -15.2 (SE 1.7) for EASI, -16.9 (SE 1.4) for POEM, -17.2 (SE 1.6) for DLQI. As for IGA and NRS pruritus, we found a trend for improvement over time. Severe (n=79) including serious (n=11) adverse events were observed in 69 patients. Eye complaints were most frequently reported (n=46). Twenty-one patients adjusted the regular dosing schedule. Fourteen patients discontinued treatment, mainly due to ineffectiveness (n=7).

Limitations: Only adverse events of severe and serious nature were registered for feasibility reasons.

Conclusion: Daily practice dupilumab treatment up to 84 weeks is generally well-tolerated, apart from the reporting of eye complaints. It can be considered a long-term effective treatment for atopic dermatitis in combination with topical and initial concomitant systemic treatment, showing a sustained improvement of signs, symptoms and quality of life.

Keywords: Atopic dermatitis; Atopic eczema; Daily practice; Dupilumab; Effectiveness; Registry; Routine clinical care; Safety; Systemic immunomodulating treatment.