INTRODUCTION
Atopic dermatitis (AD) is the most common inflammatory skin disease and is associated with psychiatric comorbidities.1 The underlying pathogenesis of AD is defined by a complex interplay involving immune dysregulation, environmental factors, and gene mutations.4 Previous systemic treatments used for severe AD were not US Food and Drug Agency (FDA)-approved and are associated with considerable side effects.1
In 2017, dupilumab, a fully human monoclonal IgG4 antibody, was approved by the FDA in adult patients with moderate-to-severe AD with failure to respond to topical therapies or when those therapies were not advised.1,4,5 It has since gained additional approval in patients aged 6 months and older. According to a meta-analysis of 10 trials in adult patients, dupilumab provided greater improvement than placebo in disease severity indexes, patient-reported outcomes, and health-related quality of life measures.7 Dupilumab has an excellent safety profile with cumulative incidence rates of adverse events associated with dupilumab occurring in a similar frequency to placebo.7 Conjunctivitis and local injection site reactions are the most commonly associated adverse events.7
Understanding the patients’ experiences, potential barriers to treatment, adverse effects, and the impact treatment may have on quality of life (QOL) may be useful for treating AD. We qualitatively assessed experience with dupilumab in adult and adolescent patients using semi-structured interviews.
In 2017, dupilumab, a fully human monoclonal IgG4 antibody, was approved by the FDA in adult patients with moderate-to-severe AD with failure to respond to topical therapies or when those therapies were not advised.1,4,5 It has since gained additional approval in patients aged 6 months and older. According to a meta-analysis of 10 trials in adult patients, dupilumab provided greater improvement than placebo in disease severity indexes, patient-reported outcomes, and health-related quality of life measures.7 Dupilumab has an excellent safety profile with cumulative incidence rates of adverse events associated with dupilumab occurring in a similar frequency to placebo.7 Conjunctivitis and local injection site reactions are the most commonly associated adverse events.7
Understanding the patients’ experiences, potential barriers to treatment, adverse effects, and the impact treatment may have on quality of life (QOL) may be useful for treating AD. We qualitatively assessed experience with dupilumab in adult and adolescent patients using semi-structured interviews.
MATERIALS AND METHODS
Participants
Following receipt of approval from the Wake Forest University of Health Science’s Institutional Review Board (IRB00078702), 16 adult and adolescent participants were recruited from Atrium Health Wake Forest Baptist Dermatology Clinic. All participants recruited had a clinical diagnosis of AD (ICD 10: L20.9) between 1/1/2017 to 1/1/2022 and had received treatment with dupilumab. Participants ranged in age from 12 to 55 years, 7 were adolescents (mean age 13.8), and 9 were adults (mean age 44.4). Nine participants were female and 7 were male. The length of time since AD diagnosis ranged from 2 to 20 years (mean 7.6 years). All patients were started on dupilumab within the past 3 years. Each participant received a unique identification code. Adult patients were identified as ADA#, while adolescent patients were identified as ADP#.
Following receipt of approval from the Wake Forest University of Health Science’s Institutional Review Board (IRB00078702), 16 adult and adolescent participants were recruited from Atrium Health Wake Forest Baptist Dermatology Clinic. All participants recruited had a clinical diagnosis of AD (ICD 10: L20.9) between 1/1/2017 to 1/1/2022 and had received treatment with dupilumab. Participants ranged in age from 12 to 55 years, 7 were adolescents (mean age 13.8), and 9 were adults (mean age 44.4). Nine participants were female and 7 were male. The length of time since AD diagnosis ranged from 2 to 20 years (mean 7.6 years). All patients were started on dupilumab within the past 3 years. Each participant received a unique identification code. Adult patients were identified as ADA#, while adolescent patients were identified as ADP#.
