Dupilumab (Dupixent) for the treatment of eczema in teenagers
In 2019, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into whether dupilumab has any advantages or disadvantages compared to optimized individual treatment for moderate to severe eczema in young patients aged 12 years and over who are able to have systemic treatment.
The manufacturer didn't provide any suitable studies involving teenagers. So IQWiG used a study involving adults instead, specifically looking at the results related to people between the ages of 18 and 39. In this age group, 52 people were given dupilumab for about half a year (300 mg of dupilumab every 2 weeks) and 189 were given a placebo (fake medication). In addition, both groups had treatment with glucocorticoid (steroid) creams. If their symptoms got worse, the treatment was individually adjusted further. The study included only people who had had moderate to severe eczema for at least three years.
What are the advantages of dupilumab?
Symptoms of the disease: Overall, the study suggests that dupilumab has an advantage in terms of eczema symptoms: People who used dupilumab experienced fewer symptoms such as dry or scaly skin.
Itching: Early results suggest that dupilumab has an advantage here: Itching improved in about 62 out of 100 people within one year. In the group that had optimized individual treatment, this only happened in about 31 out of 100 people.
Health-related quality of life: The study suggests that dupilumab is better here, too: About 33 out of 100 people who used dupilumab reported that their quality of life improved, compared to about 15 out of 100 people who had individually optimized treatment.
What are the disadvantages of dupilumab?
Eye problems: The study suggests that dupilumab has a disadvantage here.
There was no real difference between the two groups regarding sleep problems.
What remains unanswered?
The manufacturer didn't provide any usable data about overall health.
Institute for Quality and Efficiency in Health Care (IQWiG, Germany). Dupilumab (Atopic dermatitis) – Benefit assessment according to §35a Social Code Book V. Dossier assessment; Commission A17-63. February 27, 2018. (IQWiG reports; Volume 601).
Institute for Quality and Efficiency in Health Care (IQWiG, Germany). Dupilumab (Atopic dermatitis in adolescents) – Benefit assessment according to §35a Social Code Book V. Dossier assessment; Commission A19-75. November 28, 2019. (IQWiG reports; Volume 847).
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