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Peer-reviewedCC BY-NC 4.0Acta Dermato-Venereologica

Dupilumab in Atopic Dermatitis – Rate of Poor Responders and Potential Risk Factors from the TREATgermany Registry

  • Annice Heratizadeh1
  • Joëlle Naim1
  • Barbara Kind2
  • Katharina Loennecke2
  • Sascha Fischer1
  • Tatjana Honstein1
  • Stephan Traidl1,3
  • Eva Moennig1
  • Thomas Birkner2
  • Inken Harder4
  • Caroline Mann5
  • Thomas Schaefer6
24 more authors
  • Susanne Abraham7,8
  • Matthias Augustin9
  • Jutta Ramaker-Brunke10
  • Andreas Pinter11
  • Kathrin Meinhardt12
  • Sven Quist13
  • Sabine Anders14
  • Beate Schwarz15
  • Michael Schulz-Kiesow16
  • Sabine Steinke17
  • Nicole Adler18
  • Christiane Handrick19
  • Knut Schäkel20
  • Michael Sticherling21
  • Anne Bong22
  • Felix Jacobs23
  • Bernd Großmann24
  • Maren Stahl25
  • Carl-Philipp Buerkle26
  • Hannah Gorriahn-Maiterth27
  • Tilo Biedermann28
  • Stephan Weidinger4
  • Jochen Schmitt2
  • Thomas Werfel1,3
28 affiliations
  1. 1Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
  2. 2Center for Evidence-Based Healthcare, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany
  3. 3Hannover Medical School, Cluster of Excellence RESIST (EXC 2155), Hannover, Germany
  4. 4Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
  5. 5Clinic for Dermatology, University Hospital, Mainz, Germany
  6. 6Thomas Schaefer, MVZ Derma Köln, Cologne, Germany
  7. 7Department of Dermatology, Carl Gustav Carus Faculty of Medicine, TUD Dresden University of Technology, Dresden, Germany
  8. 8University Allergy Center (UAC), University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany
  9. 9Institute for Health Services Research in Dermatology Hamburg, University Medical Center Hamburg Eppendorf, Hamburg, Germany
  10. 10Practice 'Die Hautärzte' Braunschweig, Braunschweig, Germany
  11. 11Department of Dermatology, Venereology and Allergology, Clinical Research, University Hospital, Frankfurt am Main, Germany
  12. 12Practice Kathrin Meinhardt, Beckum, Germany
  13. 13Dermatology Clinic, Helix Medical Excellence Center Mainz, Mainz, Germany
  14. 14Practice Dr. med. Sabine Anders, Munich, Germany
  15. 15Practice Dr. med. Beate Schwarz, Langenau, Germany
  16. 16Practice Dr. med. Michael Schulz-Kiesow and Dr. med. Inken Reimers, Lübeck, Germany
  17. 17Hohenzollernring Dermatology Practice, Münster, Germany
  18. 18Hautärzte am Fastnachtsbrunnen, FÄ Nicole Adler, Mainz, Germany
  19. 19Practice Dr. med. Christiane Handrick, Berlin, Germany
  20. 20Department of Dermatology, University Hospital, Heidelberg, Germany
  21. 21Department of Dermatology, University, German Center for Immunotherapy, Erlangen, Germany
  22. 22Practice Dr. med. Anne Bong, Emmerich, Germany
  23. 23Practice DERMAKULM, Kulmbach, Germany
  24. 24Practice Dr. med. Bernd Großmann, Koblenz, Germany
  25. 25Practice Dr. med. Maren Stahl, Osterode, Germany
  26. 26Skin and laser medicine Kinzigtal, Practice Dr. med. Bürkle, Haslach, Germany
  27. 27Practice Dermasana, Karlsruhe, Germany
  28. 28Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
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Abstract

A distinct proportion of patients with atopic dermatitis and dupilumab treatment does not reach the primary endpoint of an eczema area severity index (EASI)-75 or investigator global assessment 0/1 after 16 weeks. Little is known about poor responders to dupilumab in real life scenarios. The study objective was to identify the percentage and characteristics of patients with insufficient treatment response to dupilumab based on “TREATgermany” registry data from dermatological routine care. Between 06/2016 and 12/2024, 476 patients matched the study criteria. In total, 4% of patients (n=19) were identified as dupilumab poor responders, i.e. reduction in EASI ≤40% at the 1st follow-up visit after 8 to 20 weeks and a consecutive 2nd follow-up visit up to 52 weeks of treatment. 44% (n=209) were classified as stable responders, i.e. decrease in EASI≥75% at both follow-up visits. Poor responders were significantly more often male, more frequently exhibited smoking, arterial hypertension and a higher body mass index. This TREATgermany data analysis demonstrates a proportion of 4% dupilumab poor responders within the first year of treatment. Male sex, smoking, arterial hypertension and increased body mass index were identified as potential risk factors. Further translational research is needed to confirm these clinical findings.

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Cite

BibTeXRIS
BibTeX
@article{heratizadeh2026dupilumab,
  title = {{Dupilumab in Atopic Dermatitis – Rate of Poor Responders and Potential Risk Factors from the TREATgermany Registry}},
  author = {Annice Heratizadeh and Joëlle Naim and Barbara Kind and Katharina Loennecke and Sascha Fischer and Tatjana Honstein and Stephan Traidl and Eva Moennig and Thomas Birkner and Inken Harder and Caroline Mann and Thomas Schaefer and Susanne Abraham and Matthias Augustin and Jutta Ramaker-Brunke and Andreas Pinter and Kathrin Meinhardt and Sven Quist and Sabine Anders and Beate Schwarz and Michael Schulz-Kiesow and Sabine Steinke and Nicole Adler and Christiane Handrick and Knut Schäkel and Michael Sticherling and Anne Bong and Felix Jacobs and Bernd Großmann and Maren Stahl and Carl-Philipp Buerkle and Hannah Gorriahn-Maiterth and Tilo Biedermann and Stephan Weidinger and Jochen Schmitt and Thomas Werfel},
  journal = {Acta Dermato-Venereologica},
  year = {2026},
  month = nov,
  doi = {10.2340/actadv.v106.adv-2026-0806},
  url = {https://doi.org/10.2340/actadv.v106.adv-2026-0806},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Dupilumab in Atopic Dermatitis – Rate of Poor Responders and Potential Risk Factors from the TREATgermany Registry
AU  - Annice Heratizadeh
AU  - Joëlle Naim
AU  - Barbara Kind
AU  - Katharina Loennecke
AU  - Sascha Fischer
AU  - Tatjana Honstein
AU  - Stephan Traidl
AU  - Eva Moennig
AU  - Thomas Birkner
AU  - Inken Harder
AU  - Caroline Mann
AU  - Thomas Schaefer
AU  - Susanne Abraham
AU  - Matthias Augustin
AU  - Jutta Ramaker-Brunke
AU  - Andreas Pinter
AU  - Kathrin Meinhardt
AU  - Sven Quist
AU  - Sabine Anders
AU  - Beate Schwarz
AU  - Michael Schulz-Kiesow
AU  - Sabine Steinke
AU  - Nicole Adler
AU  - Christiane Handrick
AU  - Knut Schäkel
AU  - Michael Sticherling
AU  - Anne Bong
AU  - Felix Jacobs
AU  - Bernd Großmann
AU  - Maren Stahl
AU  - Carl-Philipp Buerkle
AU  - Hannah Gorriahn-Maiterth
AU  - Tilo Biedermann
AU  - Stephan Weidinger
AU  - Jochen Schmitt
AU  - Thomas Werfel
PY  - 2026
DA  - 2026/11/05
JO  - Acta Dermato-Venereologica
DO  - 10.2340/actadv.v106.adv-2026-0806
UR  - https://doi.org/10.2340/actadv.v106.adv-2026-0806
AB  - A distinct proportion of patients with atopic dermatitis and dupilumab treatment does not reach the primary endpoint of an eczema area severity index (EASI)-75 or investigator global assessment 0/1 after 16 weeks. Little is known about poor responders to dupilumab in real life scenarios. The study objective was to identify the percentage and characteristics of patients with insufficient treatment response to dupilumab based on “TREATgermany” registry data from dermatological routine care. Between 06/2016 and 12/2024, 476 patients matched the study criteria. In total, 4% of patients (n=19) were identified as dupilumab poor responders, i.e. reduction in EASI ≤40% at the 1st follow-up visit after 8 to 20 weeks and a consecutive 2nd follow-up visit up to 52 weeks of treatment. 44% (n=209) were classified as stable responders, i.e. decrease in EASI≥75% at both follow-up visits. Poor responders were significantly more often male, more frequently exhibited smoking, arterial hypertension and a higher body mass index. This TREATgermany data analysis demonstrates a proportion of 4% dupilumab poor responders within the first year of treatment. Male sex, smoking, arterial hypertension and increased body mass index were identified as potential risk factors. Further translational research is needed to confirm these clinical findings.
SN  - 0001-5555
SN  - 1651-2057
ER  -