Background and Importance Atopic dermatitis (AD) is a relapsing inflammatory skin disease characterised by severe itching, skin lesions and dysregulation of the immune system. Dupilumab is an anti-IL-4/13 monoclonal antibody approved for the treatment of moderate to severe AD.

Aim and Objectives To evaluate the effectiveness and persistence of dupilumab in moderate-severe AD.

Material and Methods Observational and retrospective study of patients on treatment with dupilumab for moderate-severe AD from March 2020 to September 2023 in a tertiary hospital. Variables collected: age, sex, previous use of topical (Ct) and systemic (Ci) corticosteroids, topical tacrolimus, antihistamine and cyclosporine, dosage, and duration of treatment. The effectiveness variables are the EASI (Eczema Area and Severity Index) and IGA (Investigator Global Assessment) scales in weeks 16, 24 and 52. Treatment was considered effective when the EASI had been reduced by 50% (EASI50) and when the IGA had been reduced by <2 points. Data were obtained from the electronic medical record (Abucasis®). Quantitative variables were described as mean (minimum and maximum) and qualitative variables as percentages.

Results A total of 39 patients were included, mean age 30.7 years (4–64), 58.9% of the patients were male. 100% of the patients have worn Ct and 30% continue to wear them. 69% have taken Ci, 31% tacrolimus, 79% antihistamines, 66% cyclosporine. 56% of patients are on the 300 mg every 2 weeks regimen. The median treatment time with dupilumab in the included patients was 21.7 months (0.9–68.4). At week 16, 89.6% (n=33) of the included patients reached EASI 50, at week 24 EASI 50 was reached by 93% (n=32) and at week 52 it was reached by 100% (n=25). 63% (n=33) of the patients achieved an IGA of 0–1 at week 16, 81% at week 24 and at week 52 the percentage was 100% (n=27) achieving an IGA of 0–1. 10% of patients had treatment failure with Dupilumab, 7% switched to tralokinumab and 3% to upadacitinib.

Conclusion and Relevance Dupilumab treatment shows good persistence and effectiveness in AD, although further studies of longer duration are needed to establish the usefulness of dupilumab in long-term clinical practice conditions.

Conflict of Interest No conflict of interest.