Efficacy of Dupilumab in Children With Atopic Dermatitis - EMJ

Efficacy of Dupilumab in Children with Atopic Dermatitis

PATIENTS with atopic dermatitis (AD) frequently experience other Type 2 inflammatory conditions, such as asthma, allergic rhinitis (AR), and food allergies (FAs). These comorbidities may influence treatment outcomes, prompting this study to evaluate the impact of such conditions on the efficacy and safety of dupilumab in young children with moderate-to-severe AD. The analysis used data from a randomised, placebo-controlled study involving children aged 6 months to 5 years. Participants were stratified based on the presence or absence of caregiver-reported type 2 comorbidities at baseline.

At week 16, dupilumab demonstrated significant benefits compared to placebo, regardless of the presence of asthma or AR. A greater proportion of children achieved an Investigator’s Global Assessment (IGA) score of 0/1, indicating clear or almost clear skin, alongside a ≥75% improvement in the Eczema Area and Severity Index (EASI) (all p<0.05). Among children with FAs, significantly more achieved an IGA score of 0/1 (p=0.0007), with a near-significant trend observed in those without FAs (p=0.06).

Improvements in itch intensity, a key AD symptom, were also notable. Numerically more children with asthma and significantly more children without asthma experienced a ≥4-point reduction in the weekly average of daily Worst Scratch/Itch Numeric Rating Scale (WSI-NRS) scores (p=0.6 and p<0.0001, respectively). Comparable reductions in itch severity were observed in children with and without AR (p=0.008 and p<0.0001) and in those with or without FAs (p=0.0002 and p=0.004).

Dupilumab’s safety profile remained consistent with prior findings, and no new safety concerns emerged. These results highlight dupilumab’s efficacy in reducing the signs and symptoms of AD in children, regardless of comorbid type 2 inflammatory conditions, providing an effective therapeutic option for this challenging age group. The findings also suggest the treatment’s broad applicability across diverse patient subgroups.

Reference

Boguniewicz M et al. Dupilumab is efficacious in young children with atopic dermatitis regardless of type 2 comorbidities. Adv Ther. 2024;41(12):4601-16.

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