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Successful Dose Reduction of Dupilumab in Patients With Atopic Dermatitis
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- The authors of this study investigated the outcomes in 17 patients with atopic dermatitis who agreed to a dose reduction of dupilumab. After approximately 12 months of disease control (Eczema Area and Severity Index [EASI] 50 or higher) on standard dupilumab dosing, the doses of most patients were reduced to 300 mg every 3 or 4 weeks. A retrospective analysis showed that all patients receiving the reduced dose maintained EASI 50 at 12 months.
- Dose reduction of dupilumab in patients with long-term well-controlled atopic dermatitis may result in cost savings without sacrificing efficacy.
abstract
This abstract is available on the publisher's site.
Access this abstract nowDupilumab, an interleukin (IL)-4 and IL-13 signalling inhibitor, has shown impressive success in treatment of atopic dermatitis (AD). Following a health economic analysis, National Institute for Health and Care Excellence (NICE) recommended dupilumab 300mg alternate weekly for the treatment of moderate-to-severe AD after failure, intolerance or contraindication of one classical immunosuppressive systemic therapy and demanded that treatment continuation was justified only in those achieving an Eczema Area and Severity Index score (EASI 50) and a 4‑ point reduction in the Dermatology Life Quality Index (DLQI). The health economic analysis of the treatment is closely dependent upon the dosing, which affects the cost of therapy. Therefore, dose reduction would increase the cost effectiveness of this therapy and be cost saving in the NHS or potentially lessen the threshold for managing access to treatment.
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Successful Dose Reduction of Dupilumab in Atopic Dermatitis
Br J Dermatol 2023 Jan 20;[EPub Ahead of Print], MR Ardern-Jones, EE Buchanan, S Njungu, D O'DriscollFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
This UK group investigated the efficacy of a dose reduction of dupilumab in adult patients with atopic dermatitis (AD) after achieving clear or almost clear status. While the study was small (n = 17), most patients remained improved with a reduction in dose or dosing frequency. While the cost of 300-mg and 200-mg doses are equivalent in the UK, changing the dosing frequency would represent considerable cost savings for the National Health Service.
Adult and pediatric providers are navigating long-term use of dupilumab and the efficacy of dose reduction without a controlled trial for guidance. In practice, many of my pediatric patients with AD with well-controlled disease tolerate a reduced dosing frequency and appreciate less frequent injections. Of note, if a flare ensues, control is again achieved with on-label dosing frequency.