Dupilumab Shows Strong Efficacy in SCORAD-Based AD Assessment

Patient-oriented scores of atopic dermatitis significantly improved following 16 weeks of treatment with dupilumab, according to study authors evaluating these responses using SCORing Atopic Dermatitis (SCORAD) values and seeing 37% of their study population experiencing a 75% reduction in their SCORAD score.1

Clinicians treating the chronic inflammatory skin condition can compare SCORAD values before and after treatment to calculate a particular treatment’s effectiveness, with a maximum score of 100% and higher values indicating greater disease severity.2

The present authors recently published their findings in Drugs in Context of 100 Brazilian patients with diagnosed moderate or severe atopic dermatitis for whom dupilumab was indicated as a potential therapeutic.1 This monoclonal antibody binds to the IL-4 receptor subunit-α (IL-4Rα), and because IL-4 and IL-13 share this target, dupilumab can act on both, the authors noted.

Their patient population was 12 years and older with moderate (SCORAD index value of 20%-50%) or severe (SCORAD index value > 50%) atopic dermatitis who were indicated for and received infused dupilumab; they were followed on a biweekly basis for 16 total weeks. The median patient age was 22 years (range, 12-80), and male and female patients were equally represented.

Overall, the initial median SCORAD index value was 61.9% (range, 20.9%-99.9%), and the mean reduction for the 16 weeks was 67.4%. The most common comorbidity was rhinitis in 76%, followed by asthma and food allergy in 38% each. Just 50% of patients indicated previous immunosuppressive therapy of cyclosporine alone (22%), cyclosporine and methotrexate (14%), or methotrexate alone (10%). Factors considered for patient improvement were surface area of affected skin, skin xerosis (or dry skin), eczema severity over the past 3 days, pruritus, and interference with sleep.

Clinicians treating atopic dermatitis can incorporate SCORAD values before and after treatment to calculate a particular treatment’s effectiveness, with a maximum score of 100% and higher values indicating greater disease severity. | Image Credit: Veranika-stock.adobe.com

SCORAD index value changes were noticed as soon as week 2 of treatment, after which they plateaued but did not decrease from week 6 to week 14 and significantly dropped between weeks 14 and 16. By week 16, 72% of all patients achieved mild atopic dermatitis status (SCORAD < 25%); however, 22% also reached this milestone by week 2. Further, the ORs for reaching a SCORAD index value of less than 25% were progressive, rising from 2.75 at week 2 to 25.88 at week 8 to 90.85 at week 16.

Building on these results, 80% of patients also achieved SCORAD-50, or a 50% reduction in disease severity, at some point over the 16-week study period, with 22% reaching this by week 2, and 3% achieved SCORAD-75 by week 2.

A subanalysis of patient outcomes that considered prior use of immunosuppressants in the 50 patients who reported them also found that the progression of atopic dermatitis followed a similar course no matter the medication and that significant improvements were seen for all over the 16 weeks. However, when comparing outcomes with the patients who did not report prior use of immunosuppressants, “both achieved a similar SCORAD-50, but a higher percentage of those who had previously received immunosuppressants reached SCORAD-75,” the authors wrote.

There were no treatment discontinuations, but there were several reported adverse events: conjunctivitis (22% overall but 30% by the 4-week mark), facial erythema, localized reaction (1%), and herpes simplex (1%). Just 3 patients had a disease recurrence after initial improvement.

These new results are promising, the study authors noted, because they echo the findings of 2 previous studies, CHRONOS (NCT02260986) and Liberty AD (NCT03346434), that also used SCORAD index values to evaluate patient response to dupilumab. Still, there are limitations as well, because only half of their patients reported prior immunosuppressant use, which constricts extrapolating these findings to a wider audience; also, their study duration was limited to 16 weeks per an agreement with the drug’s manufacturer who donated the medication for this study.

“It is known that in real life, there are often limitations regarding access to immunobiological therapies due to the cost, especially when facing chronic diseases with prolonged treatment time or even continuous treatment,” the authors concluded. “Future studies with larger cohorts will be essential to confirm and expand upon these observations.”

References

1. Lopes MM, Castro APM, Ferrisse TM, Kalil J, Yang AC, Castro FM. Efficacy and safety of dupilumab in the treatment of moderate-to-severe atopic dermatitis: a real-life study. Drugs Context. 2025:14:2025-3-5. doi:10.7573/dic.2025-3-5
2. Oakley A. SCORAD. DermNet. 2009. Accessed July 14, 2025. https://dermnetnz.org/topics/scorad