Use of Extended Dosing Intervals of Dupilumab in Treatment of Atopic Dermatitis: A Systematic Review and Meta-Analysis.

In 30 seconds

This systematic review and meta-analysis assessed whether extending dupilumab dosing from every 2 weeks to every 3 or 4 weeks maintains efficacy and affects ocular adverse events in patients with well-controlled atopic dermatitis. Thirteen reports from 11 studies were included. The pooled mean difference in Eczema Area and Severity Index was 0.04 lower with extended dosing than with standard dosing (95% CI: -0.77 to 0.69), supporting comparable efficacy. Ocular adverse events were not shown to be reduced: relative risk 0.58 (95% CI: 0.28-1.21).

Key findings

• Across 13 reports from 11 studies, extended dosing had a pooled Eczema Area and Severity Index mean difference of 0.04 lower than standard dosing (95% CI: -0.77 to 0.69).
• The relative risk of ocular adverse events with extended versus standard dosing was 0.58 (95% CI: 0.28-1.21); a reduction could not be concluded.

Why it matters

For patients whose atopic dermatitis is well controlled, less frequent dupilumab dosing may preserve disease control while reducing treatment burden. However, the evidence does not establish that extending intervals prevents ocular adverse events. Distinguishing a plausible convenience benefit from an unproven safety benefit is important when interpreting dose-tapering evidence.

What to keep in mind

The review notes that the evidence base needs improvement; the abstract does not provide further detail on study quality or the included studies’ designs.