Skin type factors in dupilumab efficacy in atopic dermatitis

The use of dupilumab in the treatment of atopic dermatitis appears to benefit patients who have dark skin types more than those who have light skin types, as shown in a study.

Researchers pooled data from the Dutch TREAT NL and UK-Irish A-STAR registries to examine the treatment outcomes of dupilumab, methotrexate, and ciclosporin in atopic dermatitis patients, stratified by Fitzpatrick skin type.

The pooled sample included 235 patients (59.1 percent men, 67.7 percent White). However, 11 patients had missing data on skin types and were excluded from analyses comparing skin types. Of the remaining patients, 156 had light skin types (Fitzpatrick skin type 1–3) and 94.2 percent of them were White. Meanwhile, 68 had dark skin types (Fitzpatrick skin type 4–6), with 25 percent of them being Black African/Afro-Caribbean and 26.5 percent South Asian.

Relative to patients with light skin types, those with dark skin types were younger (19.5 vs 29.0 years; p<0.001), more likely to have follicular eczema (22.1 percent vs 2.6 percent; p<0.001) and higher baseline Eczema Area and Severity Index (EASI) scores (20.1 vs 14.9; p=0.009), and less likely to have allergic contact dermatitis (30.9 percent vs 47.4 percent; p=0.03) and previous phototherapy use (39.7 percent vs 59.0 percent; p=0.008).

Of note, patients with dark vs light skin types achieved greater mean EASI reduction over 6 months of treatment with dupilumab only (16.7 vs 9.7; adjusted p=0.032).

There were no differences found for adverse events with any treatments (p>0.05).