Efficacy of dupilumab in moderate and severe atopic dermatitis

Background: Treatment responses may differ between patients with severe versus moderate atopic dermatitis (AD). Objectives: To assess dupilumab response by baseline AD severity in adolescent and adult patients with moderate-to-severe AD. Methods: We assessed dupilumab response by baseline AD severity in 1719 patients aged =12 years with moderate-to-severe AD from five randomized, double-blind, placebo-controlled trials. Patients received subcutaneous placebo or dupilumab as monotherapy (300 mg [adults, adolescents] or 200 mg [adolescents] every 2 weeks; 16 weeks), or with concomitant topical corticosteroids (TCS) (adults; 16/52 weeks). Patients were stratified by baseline Investigator's Global Assessment (IGA) score (3 [moderate]/4 [severe]). Results: Dupilumab-treated patients with moderate AD had numerically higher absolute proportions of patients achieving IGA 0/1 (clear/almost clear) than those with severe AD; risk differences (dupilumab vs. placebo) were 18.9-35.5 for moderate AD and 16.4-34.2 for severe AD. For all other endpoints assessed, no meaningful differences or consistent response patterns between moderate and severe subgroups were observed. Conclusions: Dupilumab with or without TCS demonstrated similar efficacy in patients with moderate or severe AD.