13801 Real-world effectiveness and drug survival of dupilumab: A single-center retrospective analysis

Clinical trials have shown dupilumab is safe and effective for adults with moderate to severe atopic dermatitis (AD), but evidence of its real-world effectiveness is limited. The aim of this study was to investigate drug survival and effectiveness of dupilumab in the real-world setting and gain insight into factors affecting treatment success. We performed a retrospective chart review of patients with AD seen in an outpatient dermatology clinic at Oregon Health & Science University who started dupilumab between 2016-2018. We identified 61 patients (mean age 43 years, M/F: 37/24) with a mean therapy duration of 13.3 months. Drug survival rates were 90.1% and 81.2% at 12 and 24 months, respectively. Seven (11.5%) discontinued dupilumab with reasons including: loss of insurance coverage (n = 3), controlled AD (n = 2), conjunctivitis (n = 1), and desire to conceive (n = 1). Thirty had recorded outcome measures at 16 and 52 weeks. At 16 weeks, mean reduction in the product of body surface area and investigator’s global assessment (BSA × IGA) was 57.1%. Ten (29.4%) achieved an IGA of clear or almost clear, and 13 (38.2%) reported a patient global assessment (PtGA) of mild. At 52 weeks, mean reduction in, BSA × IGA was 90.2%. Thirteen (43.3%) achieved an IGA of clear or almost clear, and 15 (50%) reported a PtGA of mild. The results of drug survival analysis suggest dupilumab is effective in daily practice, supporting its use as a chronic therapy. In addition, the data suggest lack of insurance coverage and controlled symptoms are the most common predictors of discontinuation.