Dupilumab Improves Clinical Scores in Pediatric Patients Aged 2 to <18 Years with Uncontrolled Atopic Dermatitis: A Single-Center, Real-World Study

Abstract

Dupilumab is the first biologic agent approved for treatment of moderate to severe atopic dermatitis (AD). Phase 3 clinical trials have shown the efficacy and safety in AD children. However, real-world evidence is still scarce. Thirty-nine pediatric patients with uncontrolled AD who regularly received dupilumab were included in a single-center retrospective study. Eight patients (20.5%) were aged 2 to <6 years, fifteen (38.5%) were 6 to <12 years, and sixteen were 12 to <18 years. Changes in clinical AD scores (EASI, SCORAD, P-NRS, CDLQI, and POEM) at baseline, week 4 (W4), W10, and W16, as well as safety data were collected. At W16, the average EASI values dropped from 29.0 ± 16.2 to 5.1 ± 4.7, and 22 patients (73.3%) achieved 75% improvement in EASI. 16 patients (53.3%) achieved 75% improvement in SCORAD. Significant reduction was also observed in the changes of P-NRS, CDLQI, and POEM values. Notably, the change of clinical scores was similar among three age subgroups. At W16, the mean percent decreases in EASI for 2 to <6 years, 6 to <12 years, and 12 to <18 years, and subgroups were 67.3%, 78.5%, and 83.9%, respectively. A total of three cases of adverse effects were recorded, with conjunctivitis seen in two >6-year-old patients and the injection site reaction in one <6-year-old child. Dupilumab exhibited favorable efficacy and safety profile, including the 2 to <6 years old subgroup.