What is the role of dupilumab in the treatment of atopic dermatitis (eczema)?

Updated: Mar 13, 2019
  • Author: Brian S Kim, MD, MTR, FAAD; Chief Editor: William D James, MD  more...
  • Print
Answer

Dupilumab is a monoclonal antibody that inhibits interleukin (IL)–4 and IL-13 signaling by blocking the shared IL-4Ra and originally demonstrated efficacy in phase 2 clinical trials. [48, 49] It was approved by the US Food and Drug Administration (FDA) in 2017 for adults with moderate-to-severe atopic dermatitis not adequately controlled with topical prescription therapies or when those therapies are not advisable. In 2019, this indication was expanded to include adolescents aged 12 years or older. It is a subcutaneous injection administered every 2 weeks.

Approval of dupilumab was based on clinical trials investigating dupilumab as monotherapy (SOLO 1 and SOLO 2) and in concomitant administration with topical corticosteroids (CHRONOS). Results from the SOLO 1 (n=671) and SOLO 2 (n=708) trials showed 36-38% of patients who received dupilumab had scores of 0 or 1 (clear or almost clear) on the Investigator's Global Assessment scale compared with placebo (8-10%) (P<.001). Additionally, improvement from baseline to week 16 of at least 75% on the Eczema Area and Severity Index (EASI) was reported in significantly more patients who received each regimen of dupilumab than in patients who received placebo (P<.001).<ref>50 </ref>Approval in adolescents was based on a phase 3 trial showing statistically significant improvement of EASI-75 in the dupilumab-treated group compared with placebo. [51]

Given its unprecedented efficacy, dupilumab is emerging as a first-line therapeutic for moderate-to-severe atopic dermatitis.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!