Current treatment landscape of atopic dermatitis focusing on real-world evidence of dupilumab treatment

Abstract

INTRODUCTION: Atopic dermatitis (AD) is a prevalent chronic inflammatory skin disorder and has a considerable impact on patients' quality of life. Dupilumab, the first biologic approved for moderate-to-severe AD, is a human monoclonal antibody targeting the interleukin (IL)-4 receptor α, thereby blocking both IL-4 and IL-13 signaling, key drivers of type 2 inflammation in AD. Its introduction has marked a paradigm shift in the management of AD and paved the way for future therapies. As real-world evidence on biologics and Janus kinase (JAK) inhibitors is rapidly emerging, comprehensive and up-to-date reviews are important. AREAS COVERED: This review primarily summarizes real-world data on dupilumab, with a focus on its effectiveness and safety in clinical practice, highlighting recent findings and their implications for optimizing patient management. EXPERT OPINION: Real-world evidence consistently confirms the high effectiveness, favorable safety profile, and long-term treatment durability of dupilumab across various patient subgroups, including children, elderly, and patients with different underlying immune and genetic profiles. Additionally, dupilumab has demonstrated beneficial effects in patients with comorbid asthma and food allergies. Emerging data further support its potential safety during pregnancy, breastfeeding, and (non-)live vaccinations. Dose tapering is often successful and lowers the socio-economic impact of dupilumab.