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

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.