Real-world usage of dupilumab in an academic medical center in the southeast.

Summary: Abstract Body: Dupilumab has revolutionized the treatment of Atopic Dermatitis. Here, we aim to characterize the real-world usage of dupilumab over 2017-2022 at The Emory Clinic, Atlanta, Georgia, by describing the various diagnoses that necessitated dupilumab, rates of responsiveness as well as rates of discontinuation. Additionally, we examined the time to improvement as well as total duration of therapy, and rates of adverse reactions to medication. We performed a retrospective chart review of male and female patients at The Emory Clinic ages 18-89, on dupilumab between January 1, 2017 to December 31, 2022. Out of 398 adult patients treated with dupilumab, 145 met inclusion criteria. In addition to Atopic Dermatitis (114 patients), dupilumab was prescribed for various diagnoses including Prurigo Nodularis (8) and chronic idiopathic pruritus (18). Interestingly, dupilumab was also prescribed for pruritus associated with other diagnoses (5) including Erythema Annulare Centrifugum, Hypereosinophilic syndrome, Lichen Sclerosus et atrophicus, systemized drug hypersensitivity as well as CD30+ T cell dyscrasia. Patients were on dupilumab for a mean total duration of 2.5 years with a minimum duration of 84 days and maximum duration of 6 years (2164 days). Out of 145 patients, 135 patients demonstrated a reduction in pruritus (94.5%). Ten patients (6.9 %) did not demonstrate an adequate response to dupilumab, and five of these patients were placed on a JAK inhibitor. Eight patients (5.5 %) attempted to taper the dosing interval of dupilumab, and five patients successfully tapered to an injection every 3 to 4 weeks. Twenty-one patients (14.5%) reported adverse reactions to therapy, prompting four patients to discontinue therapy. In summary, we report the real-world usage of dupilumab to treat a variety of causes of chronic pruritus in addition to atopic dermatitis. To our knowledge, this is the first report of usage of dupilumab to treat Erythema Annulare Centrifugum, systemized drug hypersensitivity as well as CD30+ T cell dyscrasia. Ha Eun Kong¹, Anna Fischer², Raining Huo², Samantha Eco², Leslie P. Lawley¹ 1. Dermatology, Emory University School of Medicine, Atlanta, GA, United States. 2. Emory University School of Medicine, Atlanta, GA, United States. Clinical Research: Epidemiology and Observational Research