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 Nov;83(5):1375-1384. doi: 10.1016/j.jaad.2020.05.128. Epub 2020 May 30.


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 of patients with atopic dermatitis 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 the Eczema Area and Severity Index, -16.9 (SE, 1.4) for the Patient-Oriented Eczema Measure, and -17.2 (SE, 1.6) for the Dermatology Life Quality Index. We found a trend for improvement over time for the Investigator Global Assessment and Numerical Rating Scale for pruritus. 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, and 14 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 of 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.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Child
  • Child, Preschool
  • Dermatitis, Atopic / drug therapy*
  • Female
  • Humans
  • Infant
  • Male
  • Netherlands
  • Prospective Studies
  • Registries
  • Time Factors
  • Treatment Outcome


  • Antibodies, Monoclonal, Humanized
  • dupilumab