Dupilumab delivers — but many patients need more than monotherapy over time
In a US retrospective cohort (OM1 PremiOM™ AD) of 5,200 patients who started dupilumab between 2017-2021 (208 children, 430 adolescents, 4,562 adults), persistence on therapy steadily declined over 24 months. At 12 and 24 months the probability of remaining on dupilumab was 79.8% and 70.8% in children, 81.9% and 63.1% in adolescents, and 73.2% and 55.7% in adults. Concurrently, the use of supplemental treatments rose: by 24 months 31.5% of patients received additional systemic therapy and 62.1% used topical medications. These patterns suggest that a substantial proportion of patients starting dupilumab have ongoing or recurrent treatment needs not fully addressed by dupilumab alone.
For clinicians, prioritize longitudinal assessment of disease control and treatment burden in patients on dupilumab – proactively document persistence, reasons for dose changes or discontinuation, and the need for topical or systemic add‑ons. Consider earlier reassessment, shared decision‑making about combination strategies, and contributing real‑world outcome data to registries to help define best practices for sustained control.
J Drugs Dermatol. 2025;24(10):996-1002. doi:10.36849/JDD.8931
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