Long-Term Real-World Effectiveness of Dupilumab vs. Upadacitinib in Early Treatment Responders with Atopic Dermatitis: Results from Central European Health Fund Registry

While clinical trials have shown the efficacy of using dupilumab and upadacitinib to treat atopic dermatitis (AD), long-term real-world data remain limited. This retrospective cohort study, utilizing data from the Polish National Health Fund Registry, evaluates the long-term effectiveness of dupilumab versus upadacitinib in early treatment responders, focusing on sustained efficacy outcomes and high levels of skin clearance. Data from the Polish National Health Fund Registry were analyzed for 435 patients; 220 were treated with dupilumab and 215 were treated with upadacitinib, each receiving treatment for at least 40 weeks. Upadacitinib had a faster onset of action, leading to significantly higher rates of complete skin clearance compared to dupilumab at weeks 16 and 28 (EASI100 at week 16: 19.5% vs. 7.3%, <i>p</i> < 0.001; week 28: 26.5% vs. 12.7%, <i>p</i> < 0.001). Dupilumab showed continuous efficacy gains, ultimately demonstrating superiority in achieving EASI75 and EASI90 at week 40, though no significant difference was observed in achieving EASI100. Both treatments provided sustained dermatological improvement and enhanced quality of life, achieving high levels of skin clearance over the long term.