Dupilumab in Atopic Dermatitis – Rate of Poor Responders and Potential Risk Factors from the TREATgermany Registry

A distinct proportion of patients with atopic dermatitis and dupilumab treatment does not reach the primary endpoint of an eczema area severity index (EASI)-75 or investigator global assessment 0/1 after 16 weeks. Little is known about poor responders to dupilumab in real life scenarios. The study objective was to identify the percentage and characteristics of patients with insufficient treatment response to dupilumab based on "TREATgermany" registry data from dermatological routine care. Between 06/2016 and 12/2024, 476 patients matched the study criteria. In total, 4% of patients (n=19) were identified as dupilumab poor responders, i.e. reduction in EASI ≤40% at the 1st follow-up visit after 8 to 20 weeks and a consecutive 2nd follow-up visit up to 52 weeks of treatment. 44% (n=209) were classified as stable responders, i.e. decrease in EASI≥75% at both follow-up visits. Poor responders were significantly more often male, more frequently exhibited smoking, arterial hypertension and a higher body mass index. This TREATgermany data analysis demonstrates a proportion of 4% dupilumab poor responders within the first year of treatment. Male sex, smoking, arterial hypertension and increased body mass index were identified as potential risk factors. Further translational research is needed to confirm these clinical findings.