Adbry vs. Dupixent

Atopic dermatitis, commonly called eczema, is a chronic skin condition that causes dry, itchy, and inflamed skin. Many people manage mild disease with moisturizers and topical steroid creams. When flare-ups become severe or widespread, topical therapy may not be enough.

In recent years, new biologic treatments have become available for eczema that does not respond to usual treatments. The two most widely used biologics are Dupixent (dupilumab) and Adbry (tralokinumab).

This guide compares their effectiveness for eczema, side effects, ease of use, and cost to help you choose what may work best.

How do Adbry and Dupixent work for eczema?

Atopic dermatitis, or eczema, happens for several reasons at once. The skin barrier is weak, the immune system is overactive, and bacteria on the skin can grow more easily.

When the skin barrier is damaged, things like allergens and bacteria can get inside more easily. This triggers the immune system. Two signals, IL-4 and IL-13, then increase inflammation and make symptoms like itching and redness worse. They also make it harder for the skin to repair itself, so the problem keeps repeating.

• • IL-4 acts early in the immune response. It helps start and spread allergic reactions in the body. This is why it’s also linked to conditions like asthma and other allergies.

• • IL-13 acts more in the skin. It is closely tied to itching, skin damage, and long-term changes in the skin.

Blocking them can help control the disease.

Dupixent blocks both IL-4 and IL-13. This gives it a broader effect on the immune system. It can help with eczema and other related conditions like asthma.

Adbry blocks only IL-13. This makes it more focused on the skin. It may be a good option for people whose symptoms are mostly limited to eczema or who want to avoid certain side effects.

Effectiveness of Adbry vs. Dupixent in adults with eczema

Both Dupixent and Adbry improve eczema. Dupixent tends to help more patients reach at least 75% improvement in the Eczema Area and Severity Index (EASI), especially early in treatment. Adbry still works well but usually shows lower response rates. Long-term results are similar between the two.

Category	Dupixent (% of patients achieving each outcome)	Adbry (% of patients achieving each outcome)
Clear or almost clear skin (after 16 weeks, monotherapy)	36-38%	16-22%
Major improvement EASI-75 (16 weeks, with topical steroids)	64-69%	56%
Harder-to-treat patients (EASI-75)	59-63%	~64%
Long-term clear or almost clear skin (~5 years)	~68%	~67%
Long-term major improvement (~5 years)	~89%	~93%

Results were higher than placebo in all studies. See details below.

Results after 16 weeks

Dupixent shows stronger results in early treatment. About 36 to 38% of patients had clear or almost clear skin, compared to 8 to 10% on placebo. With Adbry, about 16 to 22% reached clear or almost clear skin, compared to 7 to 11% on placebo.

When used with topical steroids, about 64 to 69% of patients on Dupixent reached at least 75% improvement in their eczema (EASI), compared to 23% with placebo. With Adbry, about 56% reached this level of improvement, compared to 36% with placebo.

In harder-to-treat patients

Both drugs show similar overall improvement in more difficult cases. About 59 to 63% of patients on Dupixent reached major improvement, compared to about 30% with placebo.

With Adbry, about 64% of patients improved, compared to 50% with placebo.

Even though the results look similar, Dupixent shows a bigger improvement compared to no treatment (placebo). This suggests it may have a stronger effect, but since the studies were done separately, the comparison is not exact.

Long-term results (~5 years)

Both drugs show lasting benefits over time.

With Dupixent, after about 5 years, around 68% of patients maintained clear or almost clear skin, and about 89% maintained major improvement (at least 75% improvement on EASI).

With Adbry, around 67% had clear or almost clear skin, and up to 93% maintained major improvement.

Effectiveness of Adbry vs. Dupixent in children and adolescents with eczema

Dupixent has broader use across age groups and higher response rates in children and teens. Adbry works in adolescents but is not approved for younger children.

Category	Dupixent (% of patients achieving each outcome)	Adbry (% of patients achieving each outcome)
Adolescents, clear or almost clear skin	18-24%	18-21%
Adolescents, major improvement (EASI-75)	38-42%	28-29%
Children 6-11, clear or almost clear skin	30-33%	Not approved
Children 6-11, major improvement (EASI-75)	67-70%	Not approved
Children 6-11, itch improvement	51-58%	Not approved
Children 6 months-5 years, clear or almost clear skin	~36%	Not approved
Children 6 months-5 years, major improvement (EASI-75)	~79%	Not approved
Children 6 months-5 years, near-complete improvement (EASI-90)	~59%	Not approved
Long-term improvement (~1 year)	79-82% of patients across all age groups maintained response	Limited data

Results were higher than placebo in all studies. See details below.

Adolescents (12 to 17 years)

Both drugs work in teens, but Dupixent shows higher response rates.

With Dupixent, about 18 to 24% of patients had clear or almost clear skin after 16 weeks, compared to about 2% on placebo. Around 38 to 42% had major improvement, compared to 8% with placebo.

With Adbry, about 18 to 21% reached clear or almost clear skin, compared to about 4% on placebo. Around 28 to 29% had major improvement, compared to about 6% with placebo.

Children (6 to 11 years)

Dupixent shows strong results in this age group. Adbry is not approved here.

About 30 to 33% of children had clear or almost clear skin, compared to 11% on placebo. Around 67 to 70% had major improvement, compared to 27% with placebo.

In addition, about 51 to 58% of children had a meaningful reduction in itching, compared to only 12% with a placebo.

Younger children (6 months to 5 years)

Dupixent is also effective in younger children. Adbry is not approved for this group.

After 3 weeks with Dupixent, eczema severity dropped by about 43 to 50% in older children and 39 to 43% in younger children. Itch improved by about 23 to 45% in older children and 11 to 18% in younger children.

Higher doses generally led to better results, especially for itch.

After 1 year of treatment:

• • About 36% of children had clear or almost clear skin
  • About 79% had at least a 75% improvement in their eczema
  • About 59% had a 90% improvement, which means near-complete clearing

Long-term results

The benefits of Dupixent continued over time. After one year, EASI-75 responses were maintained in:

• • 81.2% in adolescents
  • 82% in children aged 6-11 years
  • 79.3% in children aged 6 months to 5 years

Adbry has long-term data up to 5 years, but the study included both adults and adolescents. The exact outcomes for adolescents alone are limited.

Which is more effective for eczema?

There are no studies directly comparing Dupixent and Adbry side by side. Most data come from separate clinical trials, which means we cannot say with full certainty which drug is more effective for eczema.

In one study, researchers took data from two separate studies and adjusted them to make the groups as similar as possible. This is not a perfect comparison, but it gives a rough idea.

When adjusted to be more comparable, Adbry and Dupixent perform very similarly by 32 weeks when used with topical steroids:

For itch and symptoms, results were also very similar. Patients on Adbry had a slightly greater improvement in quality of life, but the difference was small.

Also, eczema varies from person to person, so results may differ depending on the type of disease.

Here are other things to consider:

For severe or widespread eczema

Dupixent is usually better for severe or widespread eczema because it achieves higher response rates. EASI-75 was achieved by more than 60% of patients when combined with topical steroids. It also provides fast symptom relief and maintains its benefits over five years.

For head-and-neck eczema

Adbry may be preferred if eczema is predominantly on the face, scalp, or neck. There have been reports of patients on Dupixent whose overall eczema improves, but their face and neck symptoms stay the same or even get worse. This suggests that eczema in these areas may behave differently from the rest of the body.

There are a few possible reasons for this:

• • Sensitivity to certain skin yeasts
  • Hidden contact allergies
  • Different immune activity in these areas

Because Adbry targets IL-13 more specifically, it may work better for this type of eczema in some patients. In one long-term study (4 years), the number of patients with clear or almost clear skin in the head and neck area increased from about 12% at the start to over 87% after Adbry treatment.

For patients with comorbid type-2 inflammatory conditions

Dupixent is better when eczema co-exists with moderate-to-severe asthma, chronic rhinosinusitis with nasal polyps (CRSwNP), or eosinophilic esophagitis (EoE), as it is approved for these conditions and offers multi-organ benefits.

Most patients in Dupixent’s trials also had other type 2 conditions, such as:

• • asthma
  • food allergies 
  • allergic rhinitis 

Adbry currently has no approved uses beyond eczema.

Side effects and safety of Adbry vs. Dupixent

Both drugs are generally safe, but Adbry is associated with fewer eye-related side effects and lower rates of injection-site reactions.

Eye side effects (conjunctivitis)

Eye inflammation is one of the main side effects doctors consider when choosing between these drugs.

Based on their 16-week trials:

• • About 9.3% of patients on Dupixent developed conjunctivitis
  • About 7.5% on Adbry developed it

Dupixent was also linked to more severe cases.

Researchers think this may be related to how Dupixent blocks both IL-4 and IL-13, while Adbry only blocks IL-13. However, the exact cause is still not fully understood.

This has made Adbry a suitable option for patients who develop or are concerned about severe eye symptoms on Dupixent.

Injection-site reactions

Both drugs can cause reactions at the injection site, such as redness, swelling, or discomfort. However, these reactions are reported less often with Adbry.

• • In Dupixent trials, about 15 to 16% of patients had these reactions
  • With Adbry, about 6% of patients had them

Many Dupixent users describe the injection as very painful. In one review, a patient who had just started Dupixent said it felt like someone “put out a lit cigar” on their leg for about 30 seconds.

With Adbry, patient reviews often note that the needles are smaller and less painful than Dupixent’s. One user described the injection as feeling similar to an allergy shot.

Serious side effects

Both drugs have a low rate of serious side effects. In a 5-year study, Dupixent had about 6.66 serious events per 100 patient-years. Adbry shows similar long-term safety, with 6.7 events per 100 patient-years over up to 4.5 years.

Plus, neither drug has a black box warning, which means they do not carry the FDA’s “highest level” safety warning for serious or life-threatening risks. Unlike traditional immunosuppressants, they also do not require routine lab monitoring for liver or kidney toxicity. However, monitoring may still be needed if specific side effects occur.

Ease of use and injection experience

If you’re anxious about self-injection or needle pain, Adbry may be less intimidating. Users report that the injections feel similar to an allergy shot, and the possibility of extending dosing to every four weeks after achieving control reduces injection frequency. Dupixent requires injections every two weeks in adults and is often described as painful.

Dosing schedules in adults

Both Dupixent and Adbry start with a 600-mg loading dose in adults, followed by regular maintenance injections every 2 weeks.

Category	Dupixent	Adbry
Device options	Prefilled syringe or prefilled pen	150 mg prefilled syringes or 300 mg prefilled pen
Loading dose	600 mg (two 300 mg injections)	600 mg (four 150 mg syringes or two 300 mg pens)
Maintenance dose	300 mg every 2 weeks	300 mg every 2 weeks (two 150 mg syringes or one 300 mg pen)
Dosing flexibility	Fixed every 2 weeks	May switch to every 4 weeks if symptoms are well controlled after 16 weeks

Dosing schedules in pediatric patients

For pediatric patients (ages 12-17), the dosing is different. Adbry is given using prefilled syringes only. Treatment starts with a 300 mg loading dose (two 150 mg injections), followed by a 150 mg injection every 2 weeks.

On the other hand, Dupixent depends on the body weight:

Weight	Initial Dose (Loading)	Maintenance Dose	Frequency
15 kg to less than 30 kg	600 mg (two 300 mg injections)	300 mg	Every 4 weeks
30 kg to less than 60 kg	400 mg (two 200 mg injections)	200 mg	Every 2 weeks
60 kg or more	600 mg (two 300 mg injections)	300 mg	Every 2 weeks

Cost and accessibility

Both medications are expensive because they are complex biologic drugs. Based on list prices, Adbry is usually cheaper, ranging from about $2,030 to $4,052, while Dupixent costs around $4,193 for a two-pen carton.

However, studies show that Dupixent may provide more value per dollar because more patients respond well to it. In other words, you may need to spend more overall with Adbry to achieve the same level of results.

For example:

• • The cost to get one patient to 75% improvement (EASI-75) was about $163,000 with Adbry, compared to $105,000 with Dupixent.

• • The cost for one year of good-quality health (called a QALY) was about $129,400 with Adbry, compared to $110,300 with Dupixent.

Another factor that can influence treatment choice is monitoring and access to care. Dupixent is often associated with eye-related side effects, so some guidelines recommend a baseline eye exam before starting treatment. Not everyone has easy access to an eye specialist, and scheduling extra visits can add cost and delay treatment.

Bottom line

Dupixent and Adbry are effective treatments for moderate to severe eczema. Dupixent blocks both IL-4 and IL-13, leading to higher response rates and strong long-term results. Adbry targets IL-13 only, offering a more targeted approach with fewer eye side effects and injection reactions, though response rates are generally lower.

Choosing between them depends on your disease severity, age, side effects, and insurance coverage. Dupixent is often preferred for more severe or widespread disease and is also approved for children 6 months to 11 years old, while Adbry is a good option for moderate cases or patients who want fewer side effects or less frequent dosing.

Frequently Asked Questions

Sources

Simpson, E. L., Bieber, T., et.al. (2016). Two Phase 3 Trials of Dupilumab versus Placebo in Atopic Dermatitis. New England Journal of Medicine, 375(24), 2335–2348. https://doi.org/10.1056/nejmoa1610020

Blauvelt, A., De Bruin-Weller, M., et.al. (2017). Long-term management of moderate-to-severe atopic dermatitis with dupilumab and concomitant topical corticosteroids (LIBERTY AD CHRONOS): a 1-year, randomised, double-blinded, placebo-controlled, phase 3 trial. The Lancet, 389(10086), 2287–2303. https://doi.org/10.1016/s0140-6736(17)31191-1

De Bruin-Weller, M., Thaçi, D., et.al. (2017). Dupilumab with concomitant topical corticosteroid treatment in adults with atopic dermatitis with an inadequate response or intolerance to ciclosporin A or when this treatment is medically inadvisable: a placebo-controlled, randomized phase III clinical t. British Journal of Dermatology, 178(5), 1083–1101. https://doi.org/10.1111/bjd.16156

Beck, L. A., Bissonnette, R., et.al. (2024). Dupilumab in adults with moderate to severe atopic dermatitis. JAMA Dermatology, 160(8), 805. https://doi.org/10.1001/jamadermatol.2024.1536

Simpson, E. L., Paller, A. S., et.al. (2019). Efficacy and safety of dupilumab in adolescents with uncontrolled moderate to severe atopic dermatitis. JAMA Dermatology, 156(1), 44. https://doi.org/10.1001/jamadermatol.2019.3336

Paller, A. S., Siegfried, E. C., et.al. (2020). Efficacy and safety of dupilumab with concomitant topical corticosteroids in children 6 to 11 years old with severe atopic dermatitis: A randomized, double-blinded, placebo-controlled phase 3 trial. Journal of the American Academy of Dermatology, 83(5), 1282–1293. https://doi.org/10.1016/j.jaad.2020.06.054

Borland, M. (2024, October 25). LEO Pharma Presents Final Results of ECZTEND Long-Term Adbry® Trial (tralokinumab-ldrm) in Patients with Moderate-to-Severe Atopic Dermatitis (AD) at Fall Clinical 2024. Business Wire. https://www.businesswire.com/news/home/20241025193860/en/LEO-Pharma-Presents-Final-Results-of-ECZTEND-Long-Term-Adbry-Trial-tralokinumab-ldrm-in-Patients-with-Moderate-to-Severe-Atopic-Dermatitis-AD-at-Fall-Clinical-2024

Gutermuth, J., Pink, A., et.al. (2021). Tralokinumab plus topical corticosteroids in adults with severe atopic dermatitis and inadequate response to or intolerance of ciclosporin A: a placebo?controlled, randomized, phase III clinical trial (ECZTRA 7)*. British Journal of Dermatology, 186(3), 440–452. https://doi.org/10.1111/bjd.20832

Silverberg, J., Toth, D., et.al. (2020). Tralokinumab plus topical corticosteroids for the treatment of moderate?to?severe atopic dermatitis: results from the double?blind, randomized, multicentre, placebo?controlled phase III ECZTRA 3 trial*. British Journal of Dermatology, 184(3), 450–463. https://doi.org/10.1111/bjd.19573

Wollenberg, A., Blauvelt, A., et.al. (2020). Tralokinumab for moderate?to?severe atopic dermatitis: results from two 52?week, randomized, double?blind, multicentre, placebo?controlled phase III trials (ECZTRA 1 and ECZTRA 2)*. British Journal of Dermatology, 184(3), 437–449. https://doi.org/10.1111/bjd.19574

Paller, A. S., Flohr, C., et.al. (2023). Efficacy and safety of tralokinumab in adolescents with moderate to severe atopic dermatitis. JAMA Dermatology, 159(6), 596. https://doi.org/10.1001/jamadermatol.2023.0627

Paller, A., Siegfried, E., et.al. (2020). A phase 2, open?label study of single?dose dupilumab in children aged 6 months to <6 years with severe uncontrolled atopic dermatitis: pharmacokinetics, safety and efficacy. Journal of the European Academy of Dermatology and Venereology, 35(2), 464–475. https://doi.org/10.1111/jdv.16928

Paller, A. S., Siegfried, E. C., et.al. (2024). Dupilumab Safety and Efficacy up to 1 Year in Children Aged 6 Months to 5 Years with Atopic Dermatitis: Results from a Phase 3 Open-Label Extension Study. American Journal of Clinical Dermatology, 25(4), 655–668. https://doi.org/10.1007/s40257-024-00859-y

Chovatiya, R., Ribero, S., et.al. (2025). Long-Term Disease Control and Minimal Disease Activity of Head and Neck Atopic Dermatitis in Patients Treated with Tralokinumab up to 4 Years. American Journal of Clinical Dermatology, 26(4), 587–601. https://doi.org/10.1007/s40257-025-00931-1

Torres, T., Petersen, A. S., et.al. (2024). Matching-Adjusted indirect comparison of the efficacy at week 32 of tralokinumab and dupilumab in the treatment of Moderate-to-Severe atopic dermatitis. Dermatology and Therapy, 14(4), 983–992. https://doi.org/10.1007/s13555-024-01143-x

Dupixent™ (n.d.). https://www.dupixent.com/support-savings/copay-card-insurance

Leopharma. (n.d.). Adbry® AdvocateTM Program | Patient Support & Savings for Eczema Treatment [Video]. LEO Pharma. https://www.adbry.com/savings-and-support-programs/adbry-advocate

What is Adbry®? (2024, October 11). Biologic Medications. https://biologicmeds.org/approved-biologics/adbry/

Kim, Y. (2025). Comparative Efficacy and Safety of tralokinumab and dupilumab in Moderate-to-Severe Atopic Dermatitis: A Narrative review. Journal of Clinical Medicine, 14(14), 4960. https://doi.org/10.3390/jcm14144960

Gade, A., Ghani, H., Patel, P., & Rubenstein, R. (2024, February 28). Dupilumab. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK585114/

Moreau, R. A., Su, A. Y., et.al. (2024). Clinical and economic evaluation of tralokinumab for atopic dermatitis. Journal of Managed Care & Specialty Pharmacy, 30(7), 639–645. https://doi.org/10.18553/jmcp.2024.30.7.639