(392) Impact of dupilumab on healthcare resource utilization and its treatment patterns in patients with atopic dermatitis and comorbid asthma: A non-interventional study utilizing a U.S. claims database

Background: : Atopic dermatitis (AD) affects about 7% of U.S. adults and 6-11% of children, while impacting 15-20% of children and 1-3% of adults globally. Patients with AD have an increased asthma risk and reduced life quality. Although dupilumab is approved for treating both conditions, real-world data on its impact on healthcare usage, and asthma exacerbations in patients with both AD and asthma are limited.

Objective: : Evaluate dupilumab's real-world effects on healthcare use, and asthma exacerbations in patients aged 12+ with AD and asthma, over 12 months pre- and post-treatment initiation

Methods: : This retrospective, observational cohort study used the Healthcare Integrated Research Database® (HIRD®) with U.S. health claims from commercial and Medicare Advantage plans. Included were patients aged 12+ diagnosed with AD and asthma, prescribed dupilumab for AD between March 1, 2017, and April 30, 2023. The first dupilumab claim was the index event. Healthcare Resource Utilization and asthma exacerbations were measured 12 months pre- and post-index; treatment patterns including adherence and switching were assessed for 12 months post-index.

Results: : Among 1,907 patients that received dupilumab and met inclusion criteria, 60.5% were male, and 82.4% were aged 18+ at first prescription. Dermatologists prescribed dupilumab for 65.1% and allergists/ immunologists for 9.1%. Although declines in AD-related hospitalizations and ER visits are insignificant, the 12-month follow-up shows fewer overall outpatient (98.8 to 89.8%) and dermatologist visits (75.1 to 66.1%); prescription fills rose from 5.6 to 12.7 (p < 0.01). Asthma-related hospitalizations decreased (5.6% to 4.1%); ER and outpatient visits also declined (10.4% to 8.2% and 94% to 59.6%, respectively) (p < 0.01). Systemic corticosteroid and inhaled short-acting beta-2 agonists medication use also decreased. A 60-day non-refill discontinuation gap was noted in 34.3%; 30.4% restarted dupilumab after 60 days of discontinuation, and 4.0% switched to other AD-related medications. Asthma exacerbations decreased from 23.5% to 10.2%, and the episodes per patient fell from 0.3 to 0.1 (p < 0.01).

Conclusions: : In the 12 months post-dupilumab, healthcare utilization significantly declined, including fewer asthma-related hospitalizations, ER, and outpatient visits. AD-related visits decreased, while prescription fills increased, possibly driven by dupilumab use. Asthma exacerbations and frequency significantly decreased, highlighting dupilumab’s benefits in patients with AD and comorbid asthma.

Sponsorship:: Sanofi