Improvements in self-confidence and satisfaction with self-injection after introducing self-injection of dupilumab in patients with atopic dermatitis

Abstract

Dupilumab was approved for treating adult patients with atopic dermatitis (AD) refractory to topical therapy in Japan in April 2018, and self-injection of dupilumab has been available since May 2019. Subcutaneous self-injection of medication has benefits for patients and the healthcare system. However, anxiety about self-injection, lack of confidence, and the complicated procedure could prevent initiating self-injection. In this study, we assessed the experience of AD patients treated with dupilumab before and after introducing self-injection, utilizing the Self-Injection Assessment Questionnaire (SIAQ). Adult AD patients who received dupilumab by self-injection and had been treated for more than 3 months after initiating self-injection in our hospital from March 1, 2020, to June 19, 2021, were included in this study. Patients rated their perceptions about self-injections using the SIAQ before the first self-injection and 3 months after initiating self-injection. Data were collected retrospectively from their charts. Data on 36 patients were analyzed. The mean age was 34.1 ± 11.5 years. Twenty patients used a prefilled auto-injector, and the others used a prefilled syringe. Scores on self-confidence and satisfaction with self-injection significantly improved after introducing self-injection. Feelings about injections improved in patients over 40 years and in those who felt anxious about self-injection. A strong correlation in scores between satisfaction with self-injection and the ease of use was observed. The results were not affected by clinical severity, gender, or device. Our results could encourage patients who dither to introduce self-injection of dupilumab due to anxiety and/or lack of self-confidence about self-injection to initiate self-injection.