Eerste ervaringen met dupilumab in de dagelijkse praktijk

Summary Dupilumab is the first and long-awaited biologic registered for the treatment of moderate-to severe atopic dermatitis. We describe the effect of dupilumab treatment in daily practice in 58 patients treated at the Erasmus MC. In contrast to previously reported clinical trials, the majority of patients described here were using classical immunosuppressants such as cyclosporine A and methotrexate when dupilumab was initiatedand immunosupressants were often continued. The concomitant use of immunosupressants and dupilumab did not show any apparent safety concerns. Dupilumab treatment was effective in the vast majority of patients. In five patients there was no response to dupilumab treatment, which resulted in treatment discontinuation. Most patients experienced early and rapid improvement of symptoms of itch. The appearance of skin symptoms (eg. EASI scores) tends to lag behind the itch reduction. We found no adverse events related to the concomitant use of dupilumab and other oral immunosuppressive drugs. The most frequently reported side-effect was conjunctivitis.