INTRODUCTION
Atopic dermatitis (AD), also known as atopic eczema, is a chronic inflammatory disorder characterized by recurrent eczematous lesions, intense itch, and lichenification.1 Although typically beginning in childhood, AD can manifest at any point in life and can substantially impair the quality of life of affected patients and their families.2,3
Topical corticosteroids are a first-line anti-inflammatory therapy for patients with AD4,5; however, for patients with moderate-to-severe disease, more advanced therapies may be necessary.5,6 Dupilumab, an interleukin-4 receptor alpha antagonist, was the first biologic drug to be FDA-approved, in March 2017, for adults with moderate-to-severe AD whose disease was not adequately controlled with topical prescription therapies or when those therapies were not advisable.7 Dupilumab was subsequently approved for adolescent patients aged 12 to 17 years in March 2019,8 for children aged 6 to 11 years in May 2020,9 and for patients aged 6 months to 5 years in June 2022.10 Until December 2021, dupilumab was the only approved targeted biologic systemic treatment available for AD.11 Today, advanced treatment options include other biologics and various Janus kinase inhibitors (JAKis), and additional treatments are in development.5,12
Although dupilumab has demonstrated improvements in clinical and patient-reported outcomes, as well as in real-world settings, for patients with AD,13-17 some patients experience adverse events (AEs) that may prevent continued treatment, whereas others have inadequate response.17-21 Persistence, defined here as the duration from treatment initiation to discontinuation,22 has been reported for dupilumab in real-world settings, primarily among adults17,23,24; however, data on dupilumab persistence among children and adolescents are limited. Further, there is limited information about the proportion of patients with AD who supplement dupilumab with other prescription medications. The need for concomitant medications increases the cost of care, creates an additional
Topical corticosteroids are a first-line anti-inflammatory therapy for patients with AD4,5; however, for patients with moderate-to-severe disease, more advanced therapies may be necessary.5,6 Dupilumab, an interleukin-4 receptor alpha antagonist, was the first biologic drug to be FDA-approved, in March 2017, for adults with moderate-to-severe AD whose disease was not adequately controlled with topical prescription therapies or when those therapies were not advisable.7 Dupilumab was subsequently approved for adolescent patients aged 12 to 17 years in March 2019,8 for children aged 6 to 11 years in May 2020,9 and for patients aged 6 months to 5 years in June 2022.10 Until December 2021, dupilumab was the only approved targeted biologic systemic treatment available for AD.11 Today, advanced treatment options include other biologics and various Janus kinase inhibitors (JAKis), and additional treatments are in development.5,12
Although dupilumab has demonstrated improvements in clinical and patient-reported outcomes, as well as in real-world settings, for patients with AD,13-17 some patients experience adverse events (AEs) that may prevent continued treatment, whereas others have inadequate response.17-21 Persistence, defined here as the duration from treatment initiation to discontinuation,22 has been reported for dupilumab in real-world settings, primarily among adults17,23,24; however, data on dupilumab persistence among children and adolescents are limited. Further, there is limited information about the proportion of patients with AD who supplement dupilumab with other prescription medications. The need for concomitant medications increases the cost of care, creates an additional
