Dupilumab (Dupixent) for the treatment of eczema in adults
In 2018, 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 adults who are able to have systemic treatment.
The manufacturer provided one suitable study involving 425 adults whose data could be used in the analysis. Of those patients, 110 used dupilumab for about a year and 315 used 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?
Itching: The study suggests that dupilumab has an advantage here: Over the course of a year, itching improved in almost 70 out of 100 people who had treatment with dupilumab. In the group that had optimized individual treatment, this only happened in about 37 out of 100 people.
Problems sleeping: In terms of this eczema-related problem, initial analyses suggest that dupilumab has an advantage here as well. Sleep problems were less common in people who had treatment with dupilumab than they were in those who had optimized individual treatment.
Symptoms of the disease: The study suggests that dupilumab had advantages in terms of other symptoms, too: People who used dupilumab experienced fewer eczema symptoms such as dry or scaly skin.
Health-related quality of life: The study suggests that dupilumab is better than a placebo here: Almost 46 out of 100 people who used dupilumab reported that their quality of life improved, compared to about 18 out of 100 people who had individually optimized treatment.
What are the disadvantages of dupilumab?
The study suggests that dupilumab has a disadvantage in terms of eye problems. These occurred in 30 out of 100 people who used dupilumab, compared to only about 15 out of 100 people who had individually optimized treatment.
Serious side effects: No difference was found here. In each group, 4 to 6 out of 100 people had severe side effects.
No difference was found in terms of the following, either:
- Treatment stopped due to side effects
- General health
- Infections and parasitic diseases
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).
IQWiG health information is written with the aim of helping
people understand the advantages and disadvantages of the main treatment options and health
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