Dupilumab Improves DLQI and IGA Scores in Hand and Facial Eczema in Patients With Moderate to Severe AD

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Recent research by Abraham et al evaluated the response to treatment with dupilumab in patients with hand and facial eczema with simultaneous moderate to severe atopic dermatitis (AD).¹ In the poster from the 2025 American Academy of Dermatology Annual Meeting, researchers reviewed data from the TREATgermany prospective multicenter registry for adult patients with moderate to severe AD. The AD TREATgermany registry is intended for long-term follow-up.² Currently, 2250 patients have had follow-up appointments within TREATgermany. Up until December 2023, 2012 patients were enrolled in 67 centers across Germany and whose data was used for study results.

Inclusion criteria for TREATgermany included adult patients with moderate to severe AD according to the UK Working Party diagnostic criteria, an objective scoring for AD (oSCORAD) greater than 20 despite guideline-compliant topical therapy, and/or anti-inflammatory systemic therapy for AD within the past 24 months prior to inclusion in the registry. The first follow-up visit was scheduled 3 months and the second follow-up visit was after 6 months.

The first subgroup of patients (SG 1) included 455 patients with moderate to severe AD (Investigator Global Assessment [IGA] 3-5) and concurrent hand or facial eczema (IGA 3-5). In SG 1, patients reported the face (72.4%), neck (75.6%), and inner arms (78.1%) as the most affected body regions. The back of the knees (69.9%), back of the neck (67.4%), and backs of the hands (59.3%) were also highly reported. The average Dermatology Life Quality Index score was 13.9, the average Numerical Rating Scale (NRS) impairment of sleep score was 5.6, and the average NRS pruritus score was 6.9.

Out of SG 1, 270 patients received dupilumab and demonstrated an overall good response. At the 3-month follow-up visit (n=133), patient-reported facial involvement decreased to 60.8%; inner arm involvement decreased to 46.9%; and back of the hand involvement decreased to 26.9%. At the 6-month follow-up visit (n=109), patient-reported facial involvement further decreased to 53.8%; inner arm involvement decreased to 42.3%; and back of the hand involvement decreased to 25.0%.

Quality of life, measured by DLQI, improved from 13.9 to 5.5 at the first follow-up visit after 3 months. The mean IGA score for hand eczema decreased from 3.3 to 2.1 at the first follow-up visit, and the mean IGA score for facial eczema decreased from 3.3 to 2.3. Overall, 9.7% of patients achieved a local IGA score of 0/1 or an improvement of 2 points for hand eczema at the first follow-up visit, and 14% of patients achieved the same for facial eczema.

In a second subgroup (SG 2) of patients with moderate to severe hand eczema (IGA 3-5) and an overall IGA of 0-2, 12 patients were treated with dupilumab. By the first follow-up visit at 3 months, 16.7% of patients achieved a local IGA of the hands of 0/1 or an improvement by 2 points.

In SG 2, patients had an average DLQI score of 10 at the first documentation of dupilumab therapy. After starting dupilumab, the average DLQI score improved to 3.4 at the first follow-up visit and 4.6 at the second follow-up visit.

“Treatment with dupilumab in AD patients resulted in marked improvements in both hand and facial eczema, as well as enhanced quality of life,” concluded Abraham et al.

To learn more about facial and hand eczema, register to attend Revolutionizing Atopic Dermatitis in Nashville, Tennessee, June 6-7.

References

1. Abraham S, Lönnecke K, Kind B, et al. Dupilumab shows good response in treating hand and facial eczema in patients with moderate to severe atopic dermatitis -results from the TREATgermany registry. Poster presented at: 2025 American Academy of Dermatology Annual Meeting; March 7-11, 2025; Orlando, FL
2. Registry. TREATgermany. Updated March 2025. Accessed April 7, 2025. https://treatgermany.org/en/registry/