Dupilumab treatment in atopic dermatitis patients in the Netherlands versus Japan: a comparative cohort study revealing a discrepancy in patient-reported outcome measures.

Abstract

BACKGROUND\nDupilumab was equally effective among all racial subgroups in clinical trials, but a direct comparison in daily practice is lacking.\n\n\nOBJECTIVE\nTo investigate effectiveness of dupilumab in atopic dermatitis (AD) patients in the Netherlands versus Japan up to 80 weeks of treatment.\n\n\nMETHODS\nA longitudinal comparative cohort study was conducted in AD patients who were treated with dupilumab in daily practice. We used linear mixed-effects models to determine changes in time.\n\n\nRESULTS\nWe found statistically significant differences in sex, disease onset, BMI and therapeutic history between Dutch (n=208) and Japanese (n=153) patients. The baseline Eczema Area and Severity Index (EASI) score was higher in Japanese patients (23.8 v.s. 14.8), while baseline Patient-Reported Outcome Measures (PROMs) were higher in Dutch patients. EASI scores decreased quickly to a level indicating mild disease (EASI < 7), and remained low in both countries. However, PROMs showed different trajectories with better scores in Japan.\n\n\nCONCLUSION\nDupilumab showed significant, comparable, and sustained improvement of EASI scores in Japanese and Dutch patients. However, we found striking differences in the effect on PROMs between the countries, with a better outcome in Japanese patients.