Long-Term Effectiveness and Discontinuation Rates of Dupilumab in Atopic Dermatitis: A Comprehensive Literature Review

Abstract

Background: Dupilumab, an IL-4 and IL-13 antagonist, has demonstrated efficacy in treating moderate-to-severe atopic dermatitis (AD). While short-term benefits are well-documented, long-term effectiveness and safety data are crucial for evaluating sustained treatment strategies. Literature Review: A comprehensive review was conducted of studies evaluating dupilumab’s impact on patient-reported outcomes and clinical measures over various periods. Key outcomes included the Eczema Area and Severity Index (EASI), Numerical Rating Scale (NRS) for pruritus, Dermatology Life Quality Index (DLQI), and treatment satisfaction. Long-term studies indicated that dupilumab remains effective and well-tolerated over extended periods. Significant improvements in EASI scores, pruritus, and quality of life were maintained or enhanced over 36 months. Patient satisfaction remained high, with a majority reporting substantial improvement in itch (75.3%) and satisfactory disease control (80.7%). Discontinuation rates varied, with 23.8% of patients stopping treatment, primarily due to adverse events or perceived ineffectiveness. The most common adverse event was conjunctivitis. Real-world data also showed a high persistence rate, with improved compliance noted when patients administered their injections at home. Additionally, combined topical and systemic treatments were suggested as a beneficial approach for sustained management. Conclusion: Dupilumab offers sustained benefits for managing moderate-to-severe atopic dermatitis, with ongoing improvements in disease control and quality of life. Despite some discontinuations related to adverse effects and inefficacy, the overall safety profile remains favorable.