Effectiveness and safety of dupilumab in the treatment of atopic dermatitis in children (6-11 years): data from a French multicentre retrospective cohort in daily practice

Background Dupilumab is the first biotherapy available for the treatment of moderate-to-severe childhood atopic dermatitis (AD). Objective The aim of this study was to evaluate the effectiveness and safety of dupilumab in daily practice. Methods Patients aged 6-11, who had received a first dose of dupilumab, were included in this multicentre retrospective cohort study. The primary endpoint was change in SCORAD after 3 months of treatment. Secondary endpoints were change in IGA score at 3 months, proportion of patients with SCORAD50 and SCORAD75, description of adverse events and proportion of children in our cohort who would be excluded from pivotal phase 3 clinical trial. Results Eighty patients were included. After 3 months of treatment, there was a significant decrease in SCORAD (mean: 21.8 +/- 13.8 vs 53.9 +/- 18.5; P < 0.0001) and IGA (1.3 +/- 0.8 vs 3.5 +/- 0.7; P < 0.0001). Conjunctivitis was observed in 11.3% (n = 9/80); three patients experienced dupilumab facial redness (DFR); 17.5% (n = 14/80) reported injection site reactions; 6.3% (n = 5/80) discontinued treatment. 61.2% (n = 49/80) children were ineligible in the phase 3 trial. Limitations There is no control group. Because it was a real life study based on information from patient medical records in a French multicentre cohort, we cannot rule out the presence of reporting bias generated by the use of patient reported characteristics and missing information. Conclusion These real-life data confirm the efficacy and safety of dupilumab in children with moderate to severe AD extended to dyshidrosis and atopic prurigo, but it also revealed a lower frequency of DFR and conjunctivitis. However, administration in injectable form may be a barrier in this age group.

Automated summary

This study evaluated the effectiveness and safety of Dupilumab in the daily practice of children aged 6-11 with moderate-to-severe atopic dermatitis (AD). The results showed a significant decrease in disease severity scores after 3 months of treatment, as well as a lower frequency of adverse events compared to previous trials. However, the administration of injectable form may present challenges in this age group. Overall, Dupilumab is an effective and safe treatment option for children with moderate-to-severe AD.