Oral corticosteroids (OCS) impose a significant burden on patients and healthcare resources; therefore, treatments that limit their use are pivotal in atopic dermatitis (AD) and asthma management as they can help reduce the burden associated with long term OCS.
Methods:  6 adult patients, 2M/4F, mean age 35 years with chronic severe AD and severe asthma in regular treatment with OCS and immunosuppressive (cyclosporine or methotrexate) and inhales corticosteroids combined with long-acting inhaled B-agonists. Data were combined to analyze the OCS sparing potential of dupilumab/600mg loading dose followed by 300 mg maintenance/2weeks for minimum 6 months (January 2022-December 2022). AQLQ,Eczema Area and Severity Index (EASI) and Dermatology life Quality Index (DLQI) scores were evaluated. Pulmonary function was assessed by spirometry.
Results: 5 patients on OCS at baseline had been able to stop their OCS dose at the time of data collection and only one reduce the OCS dose.  At baseline, the mean EASI score was 28 ± 9.9; DLQI score 17.7 ± 4.2 and after 3 months, EASI was 5.3±4.4 and DLQI 6.7 ± 4.2 ; after 6 months 100% of patients achieving EASI 50. FEVI improved significantly from baseline to week 12. AQLQ (103 to 147 in week 24) was improved for the total patients under dupilumab and had more days with asthma control, days free of asthma symptoms and fewer nights with nighttime awakening.
Conclusions: Dupilumab is effective in improving AD unresponsive to conventional therapy in patients with severe asthma and resulted in the reduction of OCS without interference with the control of asthma symptoms.