Dupilumab for the Treatment of Atopic Dermatitis in an Austrian Cohort-Real-Life Data Shows Rosacea-Like Folliculitis

Abstract

Dupilumab is the first biological treatment approved for moderate-to-severe atopic dermatitis (AD). Efficacy and safety have been demonstrated in clinical trials, but real-life data is still limited. The objective of this study was to retrospectively evaluate Dupilumab treatment in AD patients in a real-life clinical setting. Effectiveness and safety outcomes were collected at baseline and after 2, 6, 10, 24, 39, and 52 weeks by using clinical scores for disease activity, as well as serological markers. Ninety-four patients from five dermatological hospitals were included. After 24 weeks of treatment, the median Investigator Global Assessment (IGA) and Eczema Area and Severity Index (EASI) showed a significant reduction compared to baseline (3.9 ± 0.7 vs. 1.4 ± 0.8 and 26.5 ± 12.5 vs. 6.4 ± 6.5). Interestingly, we observed rosacea-like folliculitis as an unexpected side effect in 6.4% of patients. Dupilumab proves to be an effective and well-tolerated treatment under real-life conditions. The occurrence of rosacea-like folliculitis warrants further mechanistic investigation.

A Literature Review of Real-World Effectiveness and Safety of Dupilumab for Atopic Dermatitis

“…Real-world evidence of the effectiveness and safety of dupilumab for atopic dermatitis Accumulating real-world evidence has ensured the effectiveness and tolerable safety of dupilumab both in the short term and in the long term. The articles searched in PubMed and Google Scholar are shown in Table 1 (Ariëns et al, 2020, Ariëns et al, 2021, Faiz et al, 2019, Fargnoli et al, 2020, Fargnoli et al, 2019, Jang et al, 2020, Jo et al, 2020a, Kreeshan et al, 2021, Matsutani et al, 2020, Nettis et al, 2020b, Nettis et al, 2020c, Olesen et al, 2019, Patruno et al, 2021a, Patruno et al, 2021b, Quint et al, 2020, Ribero et al, 2020, Sears et al, 2020, Tauber et al, 2019, Uchida et al, 2021, Uchida et al, 2019. Patruno et al reported the effectiveness and safety of dupilumab in elderly patients with AD in real life (Patruno et al, 2021a, Patruno et al, 2021b.…”

Type 2 innate immunity regulates hair follicle homeostasis to control Demodex pathosymbionts

“…Mechanisms that restrain the fecundity, growth and/or maintenance of follicular mites are little studied, and the models we describe will be useful to probe these pathways as well as implications for disease in the colonized host, such as tolerance to allergens or proclivity to AD. Of note, patients treated with anti-IL4Ra antagonist for atopic dermatitis have increased incidence of conjunctivitis associated with demidocosis 35 , suggesting pathways we uncover here likely participate in control of follicular mites in humans.…”

EAACI Biologicals Guidelines—dupilumab for children and adults with moderate‐to‐severe atopic dermatitis

“…Several retrospective real‐life cohorts and AD registries report similar impact of dupilumab on AD severity as in RCTs with an acceptable safety profile 83,85,86,149,150 …”