Assessment of long-term safety and efficacy of Dupilumab therapy in patients with moderate-to-severe atopic dermatitithe UAE: A real-life observational study

Background: Atopic Dermatitis (AD) is a chronic relapsing and remitting inflammatory skin disease characterized primarily scaly, pruritic, and erythematous skin lesions, all of which can have a profound negative impact on a patient’s quality of life. Dupilumab, is currently used for treating moderate-to-severe AD with promising efficacy and safety outcomes, however, limited data about long-term outcomes is available. Objective: To assess the long-term safety and efficacy of Dupilumab therapy, as well as the quality of life in patients with moderate-to-severe AD in the UAE. Methods: This retrospective observational study was conducted in Al-Qassimi and Tawam Hospitals, UAE. Patients’ data were extracted from the electronic medical records. Long-term efficacy and quality of life upon Dupilumab use were assessed by multiple validated assessment tools for patients with AD (SCORAD, EASI, DLQI/CDLQI, vIGA, and Pruritus NRS). The safety of therapy was also assessed through documented adverse events. The change in the scores of the assessment tools was determined by paired t-test and repeated measures ANOVA. Results: This study included 96 patients with moderate-to-severe AD from two hospitals in the UAE between 2019 and 2023, who were followed-up over 36 months (3 years). Mean age was 23.7±13.8 years old and nearly half of the patients were females (52.1%, n= 50). In the study sample, AD most commonly appeared on the upper (88.5%, n= 85), lower extremities (71.3%, n= 78), and head-neck region (77.1%, n= 74). There was a significant improvement in patients’ symptoms and quality of life, which was observed in SCORAD, EASI, DLQI/CDLQI, vIGA, and Pruritus-NRS scores (p<0.001) over three consequence years of receiving Dupilumab therapy (weeks 2,6,12,24,52,104, and 156). Dupilumab demonstrated considerable safety with few patients reporting side effects such as drowsiness, injection site reaction, flaring AD, and conjunctivitis. Conclusion: This study demonstrated that Dupilumab therapy was effective in the management of moderate-to-severe AD over long-term use and significantly improved patients’ quality of life with an acceptable safety profile among children and adults.