This study examined how well different dosing schedules of dupilumab maintained effectiveness in treating moderate-to-severe atopic dermatitis after patients had initially responded well to treatment. The researchers compared continuing dupilumab weekly or every 2 weeks versus switching to less frequent dosing (every 4 or 8 weeks) or stopping treatment entirely.

The researchers conducted a 36-week randomized clinical trial with 422 patients who had previously achieved good results with dupilumab in earlier studies. Patients were randomly assigned to either continue their original dupilumab schedule (weekly/every 2 weeks), switch to less frequent dosing (every 4/8 weeks), or receive placebo. They tracked disease severity, symptoms, and safety throughout the study.

The study included adult patients (average age 38 years) with moderate-to-severe atopic dermatitis who had achieved either clear/almost clear skin or at least 75% improvement in their eczema severity during previous 16-week dupilumab treatment trials. All patients had inadequately controlled disease with topical treatments before starting dupilumab.

Continuing dupilumab weekly or every 2 weeks maintained the best disease control. Less frequent dosing (every 4 or 8 weeks) led to some loss of effectiveness, while stopping treatment (placebo) resulted in significant disease worsening. The weekly/every 2 weeks groups maintained about 91% improvement in eczema severity, compared to only 70% improvement with placebo. Side effects were similar across groups, with slightly fewer adverse events in the dupilumab groups versus placebo.

The study showed that continuing dupilumab every 2 weeks provides the best long-term maintenance of disease control in atopic dermatitis. Less frequent dosing was not as effective and provided no safety advantages. The researchers recommend the approved every 2 weeks dosing schedule for long-term treatment.