Dupilumab in Real-World Adolescent Atopic Dermatitis

Dupilumab is an efficacious and safe treatment in moderate to severe adolescent atopic dermatitis (AD), according to study findings published in The Journal of the European Academy of Dermatology and Venereology.

Dupilumab’s recent approval for treatment of adolescent AD prompted researchers in Italy to investigate the real-world efficacy and safety of dupilumab in adolescents with moderate to severe AD.

They conducted a prospective, observational, multicenter, real-world study in 30 dermatological referral centers throughout Italy from December 2020 through February 2021.  Included were 139 adolescents, 12 through 17 years of age (46% female) diagnosed with moderate to severe AD, predominantly flexural eczema (84.9%), head and neck eczema (84.2%), and hand eczema (49.6%), with 88.5% exhibiting more than 1 phenotype. Participants were treated for 16 weeks with label-dosage dupilumab. Previous treatments included antihistamines (90.7%), corticosteroids (77.7%), cyclosporine A (38.9%), and phototherapy (20.1%). Most common atopic comorbidities included rhinitis, asthma, conjunctivitis, and food allergy.

After 16 weeks of dupilumab treatment, scores in the Children Dermatology Life Quality Index, Numeric Rating Scale (NRS) itch, NRS sleep loss, and Eczema Area and Severity Index showed significant improvement from baseline. Treatment was efficacious and safe in all AD phenotypes–particularly in diffuse eczema–with just more than 20% of patients reporting adverse events (AEs):conjunctivitis (10.8%), flushing (3.6%), followed by injection-site reaction, fatigue, diarrhea, headache, herpes simplex. AEs did not induce any of the patients to discontinue dupilumab treatment.

Study limitations include that more than 28% of patients had concomitant systemic therapy during the first 4 weeks, and the short follow-up period.

Researchers reported that, “Dupilumab in adolescent AD showed excellent effectiveness at week 16 with consistent improvement of all clinical scores.” They recommend longer-term observational studies, “to confirm effectiveness and safety of dupilumab in adolescent AD patients.”

Disclosure: Several study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Stingeni L, Bianchi L, Antonelli E, et al. Moderate-to-severe atopic dermatitis in adolescents treated with dupilumab: a multicentre Italian real-world experience. J Eur Acad Dermatol Venereol. August 2022;36(8):1292-1299. doi:10.1111/jdv.18141