DUPILUMAB maintained long-term effectiveness and safety in children with moderate to severe atopic dermatitis (AD), with controlled disease sustained over three years and 80.1% of patients remaining on treatment. These findings provide further insight into the real-world use of dupilumab in children with atopic dermatitis, including factors that may influence how long treatment is continued across different paediatric age groups.
The multicentre prospective cohort study included 309 children with AD treated with dupilumab across four academic and three nonacademic hospitals in the Netherlands between November 2019 and October 2025. Patients had a mean age of 10.2 years, with 51 children aged 6 months to 5 years, 120 aged 6–11 years and 138 aged 12–16 years.
Clinical outcomes were assessed using the Eczema Area and Severity Index (EASI), Investigator Global Assessment and Numeric Rating Scale (NRS) scores for pruritus and pain, alongside quality-of-life measures and adverse events.
Most patients maintained controlled AD during follow-up. After three years, mean EASI was 3.4 (95% confidence interval [CI]: 2.4–4.5), while mean NRS for pruritus was 3.6 (95% CI: 3.1–4.1).
However, outcomes varied between age groups. Children aged 6 months to 5 years consistently reported higher pruritus and quality-of-life scores than older children, with statistically significant differences in these measures over time.
The most frequently reported adverse event was dupilumab-associated ocular surface disease, occurring in 113 patients (36.6%).
Fifty patients (16.2%) discontinued dupilumab, most commonly because of ineffectiveness in 19 patients (38.0%), adverse events in 15 (30.0%), or administration problems in 11 (22.0%). Most discontinuations occurred within the first 1.5 years of treatment.
Three-year drug survival was 80.1%. Allergic asthma, allergic rhinitis and being aged 6–11 years were associated with a lower risk of treatment discontinuation.
The researchers concluded that dupilumab demonstrated long-term effectiveness and safety across paediatric age groups in a clinical setting. The higher pruritus and quality-of-life scores among younger children, alongside more frequent discontinuation related to administration problems, highlighted age-specific challenges in long-term treatment.
Reference
Vroman F et al. Long-term effectiveness, safety, and survival of dupilumab in pediatric atopic dermatitis. JAMA Dermatol. 2026;DOI:10.1001/jamadermatol.2026.3548.
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