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  • Atopic dermatitis in childhood and adolescence

Dupilumab proves itself in daily practice

    • Allergology and clinical immunology
    • Dermatology and venereology
    • Education
    • Pediatrics
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    • Studies
  • 2 minute read
In the “BioDay Registry” study, treatment with dupilumab in pediatric patients with atopic dermatitis in a “real world” setting resulted in significant improvement in disease severity and associated symptoms. Tolerability was found to be good, and the safety profile is consistent with results from clinical trials.

Dupilumab has been shown to be an effective and safe treatment for atopic dermatitis (AD) to date [1]. By binding to the IL-4Rα subunit of the IL-4 and IL-13 receptor complexes, the monoclonal antibody specifically inhibits the proinflammatory effects of these two key cytokines [1]. In Switzerland, dupilumab (Dupixent®) is approved for patients with AD aged 6 years and older [1]. To investigate the treatment effects of dupilumab in pediatric AD patients in a “real world” setting, the “BioDay Registry” study was conducted [2]. In this prospective cohort study, dupilumab-treated children (≥6 to <12 years) and adolescents (≥12 to <18 years) with moderate to severe AD were studied. Patients with a body weight <60 kg received dupilumab (s.c.) every two weeks (q2w) after an initial loading dose of 400 mg. In patients with a body weight ≥60 kg, 600 mg was administered as a loading dose, followed by 300 mg q2w. Children weighing 15-60 kg received 300 mg at baseline and after 2 weeks, and then 300 mg dupilumab every four weeks. Concomitant treatment with topical corticosteroids was allowed.

At the survey time points in week 0 (baseline) and in week 4, 16 and 28 the severity of the disease was assessed by validated scores: “Eczema Area and Severity Index” (EASI), “Investigator Global Assessment” (IGA), “Numeric Rating Scale” (NRS) for itching and pain, “Patient-Oriented Eczema Measure” (POEM) [2]. In addition, serum biomarkers associated with severity were measured.

Of the 61 patients included, 75.4% and 49.2% achieved an EASI-50 and EASI-75 response, respectively (Fig. 1) [2]. The EASI-90 response rate was 24.6%. Lesion-free or nearly lesion-free according to the IGA score was 36.1%. An improvement of ≥4 points in POEM was achieved by 84.7%, whereas this proportion was 45.3% and 77.4% for NRS itch and NRS pain, respectively. Biomarkers TARC, PARC, periostin, sIL-2Ra, and eotaxin-3 decreased significantly during treatment. The p-EASI showed a significant correlation with disease severity. The most common adverse events were conjunctivitis (n=10) and headache (n=4) (Table 1).

Literature:

  1. Drug Information, www.swissmedicinfo.ch,(last accessed 04/13/2013).
  2. Kamphuis E, et al: Dupilumab in daily practice for the treatment of pediatric atopic dermatitis: 28-week clinical and biomarker results from the BioDay registry. Pediatr Allergy Immunol 2022; 33(12): e13887.

DERMATOLOGY PRACTICE 2023; 33(2): 52

Autoren
  • Mirjam Peter, M.Sc.
Publikation
  • DERMATOLOGIE PRAXIS
Related Topics
  • Atopic dermatitis
  • BioDay Registry
  • Childhood and adolescence
  • Compatibility
  • Dupilumab
  • dupixent
  • pediatric patients
  • Real World
  • Severity
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