MANCHESTER, UK — People with atopic eczema were more likely to continue treatment with dupilumab for longer compared with methotrexate or ciclosporin, according to new data presented here at the British Association of Dermatologists (BAD) 2026 Annual Meeting.

Man Fung Tsoi, MPhil, PhD, a research associate for the UK-Irish Atopic Eczema Systemic Therapy Register (A-STAR) based at King’s College London, UK, reported that researchers analysed more than 1300 separate treatment courses, including 820 with dupilumab, 68 with subcutaneous methotrexate, 334 with oral methotrexate, and 159 with ciclosporin. At 1 year, an estimated 82% of dupilumab courses were still being continued — called the drug survival rate — compared with 60% of subcutaneous methotrexate courses, 53% of oral methotrexate courses, and 33% of ciclosporin courses. 

Fung Tsoi also reported that the risk for discontinuation compared with dupilumab was more than twice as high for subcutaneous methotrexate, almost four times as high for oral methotrexate, and nearly six times as high for ciclosporin. 

Other key findings were that dupilumab had the highest rate of drug survival at 1 year in both patient groups aged younger and older than 16 years. Dupilumab also had the highest continuation rate when the researchers looked specifically at treatment courses stopped because of adverse events. Among patients receiving dupilumab, continuation rates were similar regardless of whether they had previously tried conventional systemic treatment, such as methotrexate or ciclosporin, one or more times. 

Fung Tsoi reported that prior data from A-STAR showed that dupilumab and ciclosporin had “superior” treatment effectiveness compared with methotrexate. 

Dupilumab Use in Real-Life Practice 

The A-STAR data provides further insight into the real-world effectiveness of systemic eczema treatments such as dupilumab, said Carsten Flohr, BM BCh, PhD, chief investigator for A-STAR, speaking with Medscape News UK. 

“Dupilumab was the first advanced therapy we had coming into eczema,” said Flohr, who is head of paediatric and population-based dermatology research at St John’s Institute of Dermatology, King’s College London. 

The A-STAR findings are important, he said, because they show that dupilumab performs well not only in clinical trials, but also in routine UK practice, where patients often receive it only after an older systemic treatment has not worked well enough or could not be continued.

A-STAR Analysis 

There are 64 sites that contribute data to A-STAR’s registry: four in Ireland and 60 in the UK. As of June 2026, 1600 patients who had received systemic treatment for atopic eczema with biologics, conventional systemic therapies, and JAK inhibitors were enrolled in the registry. At this data cutoff point, 2300 treatment episodes and 6400 follow-up visits were recorded. 

The analysis presented during the session included 1381 treatment episodes among paediatric and adult patients. Across the treatment groups, mean age was about 26-30 years, and median disease duration was about 18-22 years.

The majority (59%) of treatment episodes involved dupilumab, with 24% involving oral methotrexate, 5% subcutaneous methotrexate, and 12% ciclosporin. 

Co-chair of the session, Laura Savage of Leeds Teaching Hospitals NHS Trust, asked Fung Tsoi, “I see the systemic therapies don’t necessarily affect how the biologics work. Do you think this is going to change our practice?”

Fung Tsoi replied, “We didn’t include the patients who have zero previous conventional systemic treatment in this study,” so that would be something to look at in future. Also, further analyses would be performed to stratify drug survival by reasons for discontinuation. 

The findings may help guide physicians in daily practice because how long patients remain on a medication is commonly used as a marker of a treatment’s effectiveness and tolerability, Fung Tsoi and colleagues noted in their abstract.

A-STAR is run by BAD, with funding from AbbVie, Almirall, Incyte Dermatology, Galderma, Pfizer, and Sanofi, and in partnership with the British Skin Foundation, Centre for Health Economics, Eczema Outreach, and Eczema UK (formerly the National Eczema Society). Fung Tsoi reported no relevant financial relationships. Flohr reported receiving research funding from Sanofi and Pfizer, and fees for acting as an advisor, consultant, or educator for AbbVie, Almirall, Amgen, Apogee, Bioderma, LEO, Medac, Pfizer, Roche, Regeneron, Sanofi, and the Singaporean Ministry of Health. 

Sara Freeman, BSc, MSc, is a freelance medical journalist based in London. She has been reporting for specialist healthcare news organisations for more than 20 years.