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Centre de Preuves en Dermatologie Best practice guidelines

Guidelines atopic dermatitis Updated on Jul 25

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The information provided by this website comes from sources deemed reliable. However, the Société Française de Dermatologie recommends that the user ensure the validity of this information. Some may prove to be erroneous or be subject to typos or display errors.

The use of this data is under the sole responsibility of the user. The Société Française de Dermatologie cannot be blamed for a misinterpretation of the data provided by the site, or in the event of erroneous information. This decision tree and all the contents of this site have been developed in the context of updated data from science according to the HAS methodology, expert opinions and reviewers of the various documents and in the context of the French healthcare system.


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Biotherapies

Dupilumab: in adult patients and children from 6 months of age

Dupilumab is a human IgG4 monoclonal antibody that binds to the α-subunit of the IL-4 receptor, which is part of the IL-4 and IL-13 receptor complex.

In France, it has Marketing Authorization (MA) and reimbursement for the treatment of moderate-to-severe AD in adults and children from 6 months of age (it is also indicated for moderate-to-severe asthma, eosinophilic esophagitis, and chronic rhino-sinusitis with nasal polyps, thus covering several type 2 inflammatory diseases).

In adults:

Recommended dose:
  • 300 mg every 2 weeks after a loading dose of 600 mg at treatment initiation.

Treatment is generally well-tolerated, but a certain number of patients develop conjunctivitis (approximately 20% of patients in real-world studies), most of which are mild to moderate in intensity.

Management, in collaboration with ophthalmologists, using tear substitutes and then topical anti-inflammatories if necessary is required, without the need to interrupt dupilumab treatment.

No additional laboratory tests are required for the initiation or monitoring of the treatment.

Concomitant use of emollients, TCS, TCIs, and phototherapy is possible.


Dupilumab is authorized for AD in children starting from 6 months of age.

It is indicated from 6 months to 17 years as a 1st line systemic treatment for AD (moderate-to-severe for ages 6-17 and severe for ages 6 months to 5 years) after the failure of TCS.

In children, the dosage is as follows:

From 6 months to 5 years:
From 6 years to 11 years:
From 12 to 17 years:

Lebrikizumab


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