TOPLINE

In an exploratory analysis, dupilumab restored intraepidermal nerve fibre density (IENFD) in patients with moderate-to-severe atopic dermatitis (AD) to levels similar to those seen in healthy control individuals.

METHODOLOGY

• Researchers conducted a phase 4, open-label, healthy controlled exploratory study including 31 adult patients with moderate-to-severe chronic AD from Germany and the US.
• Patients received dupilumab 300 mg every 2 weeks for 16 weeks. Skin biopsies (4 mm in diameter) were collected at baseline from pruritic lesional skin and at week 16 from non-pruritic, postlesional healed, or healing skin, with localisation matched to the baseline biopsy.
• Skin biopsies of healthy skin were collected from 10 healthy control individuals, matched for age, sex, race, and biopsy site.
• The primary endpoint was a change in IENFD at week 16 from baseline, measured as the number of nerve fibres crossing the basement membrane per millimetre of epidermis (fibres/mm).

TAKEAWAY

• At baseline, patients with AD had lower IENFD than healthy control individuals (mean difference [MD], -4.7 fibres/mm; P = .0857).
• The mean IENFD in patients with AD increased from 7.7 fibres/mm at baseline to 12.1 fibres/mm at the end of treatment at week 16 (MD, -4.3 fibres/mm; P = .0017).
• At week 16, IENFD in patients with AD was similar to that seen in healthy control individuals (MD, -0.28 fibres/mm; P = .94).
• Treatment with dupilumab showed improvements in the Eczema Area and Severity Index score (22.5 vs 5.1) and peak pruritus numeric rating scale score (8.5 vs 3.1) from baseline to week 16.

IN PRACTICE

"This study demonstrates that dupilumab treatment significantly increased IENFD in lesional skin of patients with AD to a level similar to that observed in healthy controls," the authors wrote.

SOURCE

The study was led by Konstantin Agelopoulos, Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany. It was published online on June 23, 2026, in the British Journal of Dermatology.

LIMITATIONS

The study was limited by the small sample size and open-label design.

DISCLOSURES

The study was funded by Sanofi and Regeneron Pharmaceuticals, Inc. and by the Deutsche Forschungsgemeinschaft (German Research Foundation). Few authors reported serving as investigators; receiving grants or research funding; or having advisory board membership for Sanofi, Regeneron Pharmaceuticals, Inc., and various other pharmaceutical companies. Three authors reported being employees of and/or potentially holding stock options in Sanofi. Full disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.