Real-world data reveal dupilumab persistence drops over two years, and many AD patients still require add-on treatments—highlighting major unmet needs.
CHAPEL HILL, NC, UNITED STATES, December 1, 2025 /
EINPresswire.com
/ -- A landmark real-world study published in the October 2025 issue of the Journal of Drugs in Dermatology reveals that, over a 24-month period, persistence on Dupilumab drops substantially — and a large proportion of patients require supplemental systemic or topical therapies to manage their
atopic dermatitis
. The findings highlight an ongoing and substantial unmet medical need in the AD community.
The study, titled “Real-World Dupilumab Persistence in United States Children, Adolescents, and Adults With Atopic Dermatitis Over 24 Months,” drew upon data from the OM1 PremiOM™ AD dataset and included 5,200 patients across all age groups who initiated Dupilumab between March 2017 and September 2021. Investigators included researchers from industry and academia — among them, Stefan C Weiss, MD of Trillium Dermatology (Chapel Hill, NC).
Key Findings: Real-world data from 5,200 U.S. children, adolescents, and adults show declining drug persistence requiring additional therapies to achieve adequate disease control.
Dupilumab persistence falls across all age groups: At 12 months, the probability of remaining on therapy was 79.8% for children, 81.9% for adolescents, and 73.2% for adults. By 24 months, these rates dropped to 70.8%, 63.1%, and 55.7%, respectively. Supplemental treatment is common: By the 2-year mark, 31.5% of patients had received additional systemic therapy, and 62.1% used topical medications. Implication: More than a third of patients required systemic therapy in addition to Dupilumab, and nearly two-thirds still depended on topical agents — indicating that for many, Dupilumab alone was insufficient for sustained disease control. These findings carry important clinical implications: while Dupilumab remains a cornerstone in moderate-to-severe AD management, its long-term effectiveness in “real life” may often require combination therapy, frequent re-evaluation, and adjustments — underscoring that the need for more durable, comprehensive strategies remains unfilled.
Why These Results Matter: The Reality of Chronic Atopic Dermatitis
Atopic dermatitis is not a temporary childhood rash — for many, it's a lifelong, often relapsing condition characterized by inflammation, persistent itch, disrupted sleep, and a significant burden on quality of life. "While clinical trials have established Dupilumab’s efficacy and safety," says Dr. Weiss, "real-world use across diverse populations and over longer timeframes is essential to understand 'everyday outcomes.'” This JDD analysis fills that gap, providing robust evidence across age groups and care settings. Importantly, the results challenge the assumption that a biologic therapy alone will always provide long-term, monotherapy-based control. Instead, they highlight that many patients will continue needing topical and systemic therapies — which has implications for cost, adherence, patient burden, and long-term management strategies. For dermatologists, payers, and patient advocates, these findings should prompt continued evaluation of treatment plans, earlier consideration of combination or step-up therapies, and realistic discussions with patients about expectations and goals.
Words from Dr. Stefan Weiss, MD — Co-Author & Practicing Dermatologist in Chapel Hill
"As a clinician who treats many patients with moderate-to-severe atopic dermatitis, I helped author this paper not to diminish the value of Dupilumab — which has transformed care for many — but to highlight what we still face as a community,” said Dr. Weiss. “For a significant portion of patients, Dupilumab alone isn’t enough to maintain disease control over two years. The fact that nearly one-third required additional systemic therapy and over 60% needed topical medications underscores real unmet needs in chronic AD management. We owe it to our patients to recognize that AD often requires a dynamic, long-term, and sometimes multi-modal approach — not a ‘set it and forget it’ prescription.” Dr. Weiss added that these data can inform shared decision-making, personalized care planning, and advocacy for expanded therapeutic options — including emerging biologics, small molecule therapies, and integrated skin-care regimens.
For Patients, Providers, and Stakeholders, this study has significant implications:
1. Reassess long-term management plans — Monitor persistence, supplementation needs, and patient-reported outcomes over time.
2. Adopt a proactive care model — Be prepared to recommend adjunct therapies, adjust dosing intervals, or consider alternative/combination treatments.
3. Engage in shared decision-making — Set realistic expectations, discuss potential need for add-on therapy, and revisit goals regularly.
4. Understand that AD is often chronic and may require multi-modal therapy. Dupilumab is a powerful tool — but many patients still depend on topical or systemic treatments to maintain control.
5. Don’t hesitate to speak up about symptoms or flares. If skin remains active or flares recur, it may warrant therapy adjustments rather than assuming the biologic has failed.
6. Work with your dermatologist on a long-term care plan. Treatment may evolve over time; commitment to follow-up and honest communication matters.
7. Support comprehensive, long-term care models. Chronic skin diseases like AD require dynamic management — strict “one drug fits all” coverage may leave many patients undertreated.
8.Invest in ongoing research and innovation. More durable, effective, and tailored therapies are needed — especially for patients who struggle with persistence or require additional medications.
9. Facilitate registries and real-world outcome tracking. Evidence from daily practice helps shape guidelines, inform reimbursement, and improve patient care.
The authors note several limitations of the retrospective study: lack of detailed data on reasons for discontinuation (e.g., side effects, cost, patient preference), limited insight into disease severity over time, and variable follow-up influenced by insurance and registry censoring. Nevertheless, the robust sample size (5,200 patients) and inclusion of pediatric, adolescent, and adult populations make this analysis one of the largest and most comprehensive real-world studies of Dupilumab persistence to date.About Atopic Dermatitis (AD)
Concluding Perspective
The publication of this real-world persistence study in JDD underscores the progress enabled by Dupilumab — a transformative biologic that has improved countless lives. Yet, the data also reveal a sobering truth: for many with atopic dermatitis, Dupilumab alone may not be enough.
About Trillium Dermatology
Trillium Dermatology, based in Chapel Hill, NC, is a comprehensive dermatology practice providing medical, surgical, and cosmetic skin care services to patients across the Triangle and surrounding regions. Under the leadership of board-certified dermatologist Dr. Stefan Weiss — the clinic emphasizes evidence-based care, patient education, and holistic management of chronic skin diseases.
Stefan Weiss
The Trillium Clinic PLLC
+1 9197108100
info@trilliumclinic.com
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