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

Authors

  • Annice Heratizadeh Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany https://orcid.org/0000-0002-9231-9865
  • Joëlle Naim Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany https://orcid.org/0009-0001-0084-6554
  • Barbara Kind Center for Evidence-Based Healthcare, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany https://orcid.org/0009-0002-5254-6411
  • Katharina Loennecke Center for Evidence-Based Healthcare, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany https://orcid.org/0009-0000-5565-0615
  • Sascha Fischer Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
  • Tatjana Honstein Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany https://orcid.org/0009-0001-2897-964X
  • Stephan Traidl Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany; Hannover Medical School, Cluster of Excellence RESIST (EXC 2155), Hannover, Germany https://orcid.org/0000-0003-4806-599X
  • Eva Moennig Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
  • Thomas Birkner Center for Evidence-Based Healthcare, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany https://orcid.org/0000-0002-1027-7295
  • Inken Harder Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany https://orcid.org/0000-0002-3079-0440
  • Caroline Mann Clinic for Dermatology, University Hospital, Mainz, Germany
  • Thomas Schaefer Thomas Schaefer, MVZ Derma Köln, Cologne, Germany
  • Susanne Abraham Department of Dermatology, Carl Gustav Carus Faculty of Medicine, TUD Dresden University of Technology, Dresden, Germany; University Allergy Center (UAC), University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany https://orcid.org/0000-0001-7457-6481
  • Matthias Augustin Institute for Health Services Research in Dermatology Hamburg, University Medical Center Hamburg Eppendorf, Hamburg, Germany https://orcid.org/0000-0002-4026-8728
  • Jutta Ramaker-Brunke Practice 'Die Hautärzte' Braunschweig, Braunschweig, Germany
  • Andreas Pinter Department of Dermatology, Venereology and Allergology, Clinical Research, University Hospital, Frankfurt am Main, Germany https://orcid.org/0000-0002-1330-1502
  • Kathrin Meinhardt Practice Kathrin Meinhardt, Beckum, Germany https://orcid.org/0009-0005-7826-5353
  • Sven Quist Dermatology Clinic, Helix Medical Excellence Center Mainz, Mainz, Germany
  • Sabine Anders Practice Dr. med. Sabine Anders, Munich, Germany
  • Beate Schwarz Practice Dr. med. Beate Schwarz, Langenau, Germany
  • Michael Schulz-Kiesow Practice Dr. med. Michael Schulz-Kiesow and Dr. med. Inken Reimers, Lübeck, Germany
  • Sabine Steinke Hohenzollernring Dermatology Practice, Münster, Germany
  • Nicole Adler Hautärzte am Fastnachtsbrunnen, FÄ Nicole Adler, Mainz, Germany
  • Christiane Handrick Practice Dr. med. Christiane Handrick, Berlin, Germany
  • Knut Schäkel Department of Dermatology, University Hospital, Heidelberg, Germany https://orcid.org/0000-0001-6344-7799
  • Michael Sticherling Department of Dermatology, University, German Center for Immunotherapy, Erlangen, Germany https://orcid.org/0000-0001-9396-3938
  • Anne Bong Practice Dr. med. Anne Bong, Emmerich, Germany
  • Felix Jacobs Practice DERMAKULM, Kulmbach, Germany
  • Bernd Großmann Practice Dr. med. Bernd Großmann, Koblenz, Germany
  • Maren Stahl Practice Dr. med. Maren Stahl, Osterode, Germany
  • Carl-Philipp Buerkle Skin and laser medicine Kinzigtal, Practice Dr. med. Bürkle, Haslach, Germany
  • Hannah Gorriahn-Maiterth Practice Dermasana, Karlsruhe, Germany
  • Tilo Biedermann Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany https://orcid.org/0000-0002-5352-5105
  • Stephan Weidinger Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany https://orcid.org/0000-0003-3944-252X
  • Jochen Schmitt Center for Evidence-Based Healthcare, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany https://orcid.org/0000-0003-0264-0960
  • Thomas Werfel Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany; Hannover Medical School, Cluster of Excellence RESIST (EXC 2155), Hannover, Germany https://orcid.org/0000-0001-6830-7672

DOI:

https://doi.org/10.2340/actadv.v106.adv-2026-0806

Keywords:

atopic dermatitis, dupilumab, patient characteristics, poor responder, treatment response

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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Published

2026-11-05

How to Cite

Heratizadeh, A., Naim, J., Kind, B., Loennecke, K., Fischer, S., Honstein, T., … Werfel, T. (2026). Dupilumab in Atopic Dermatitis – Rate of Poor Responders and Potential Risk Factors from the TREATgermany Registry. Acta Dermato-Venereologica, 106, adv–2026. https://doi.org/10.2340/actadv.v106.adv-2026-0806

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