Effectiveness and safety of dupilumab for the treatment of atopic dermatitis in a real-life French multicenter adult cohort

Background: Dupilumab is the first biologic available to treat atopic dermatitis (AD). Its effectiveness and safety were demonstrated in clinical trials. Objective: We sought to assess the effectiveness and safety of dupilumab in adults with AD in a real-life French multicenter retrospective cohort. Methods: We included patients treated during March 2017-April 2018. Efficacy outcomes, including Scoring Atopic Dermatitis (SCORAD) and Eczema Area and Severity Index (EASI) scores, were collected at baseline and 3 months when available. Adverse events (AEs) were recorded at follow-up. Results: We included 241 patients. The median 6 interquartile range (IQR) follow-up time was 3.8 +/- 3.7 months. A >= 75% improvement in SCORAD was achieved in 27 of 163 (16.6%) patients, and a >= 75% improvement in EASI was achieved in 40 of 82 (48.8%) patients. The median SCORAD and EASI scores at 3 months were significantly lower than those at baseline (SCORAD +/- IQR, 25 +/- 21 vs 56 +/- 27.4, P < 10(-9) and EASI +/- IQR, 4.1 +/- 6.8 vs 17.9 +/- 15.4, P < 10(-9), respectively). Conjunctivitis was reported in 84 of 241 (38.2%) patients. The proportion with eosinophilia (<500 cells/mm(3)) during follow-up (57%) was higher than that at baseline (33.7%) (n = 172, P < 10(-6)). Dupilumab was stopped in 42 cases; 27 patients stopped because of AEs. Limitations: No control group, missing data. Conclusion: This real-life study demonstrated a similar dupilumab effectiveness as that seen in clinical trials, but it also revealed a higher frequency of conjunctivitis and eosinophilia.