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Evaluating Outcomes of Live-Attenuated Vaccine Administration in Pediatric Patients on Dupilumab for Atopic
Grace Eleanor Sessler Bruess1, Kelly K Barry1, Gerilyn M Olsen1
1Department of Dermatology, Medical College of Wisconsin, Milwaukee, USA.
Insights
This study examined live vaccine safety in children with atopic dermatitis (AD) on dupilumab therapy. While most tolerated vaccines, some experienced adverse events, warranting further investigation.
Area of Science:
- Immunology
- Dermatology
- Pediatrics
Background:
- Dupilumab, an IL-4Rα and IL-13 inhibitor, treats atopic dermatitis (AD) in children aged 6 months and older.
- Current guidelines advise against live-attenuated vaccines in patients on dupilumab due to insufficient safety data.
Purpose of the Study:
- To evaluate the safety and effects of live vaccines in pediatric patients receiving dupilumab for AD.
- To assess adverse events associated with live vaccines, including in children receiving their primary vaccination series.
Main Methods:
- Retrospective chart review of 233 pediatric patients (6 months to 10 years) with AD treated with dupilumab.
- Analysis of patients who received live vaccines during the study period, noting any reported adverse events.
Main Results:
- Nineteen out of 233 patients received live vaccines while on dupilumab therapy.
- Four patients reported adverse events, with one requiring hospitalization.
Conclusions:
- Live vaccine administration in children with AD on dupilumab appears generally safe but requires careful monitoring.
- Further research is needed to fully understand the safety profile, especially in the context of primary vaccine series.
Abstract:
Dupilumab is an IL-4Rα and IL-13 inhibitor FDA-approved for the treatment of atopic dermatitis (AD) in patients 6 months and older. Guidelines recommend against live-attenuated vaccines due to limited safety data. We conducted a retrospective chart review of 233 patients aged 6 months to 10 years receiving dupilumab for AD at Children's Wisconsin, which showed that 19 received live vaccines during the study period. Four patients reported adverse events, including one requiring hospitalization. This study aims to evaluate the effects of live vaccines in children on dupilumab therapy and to assess associated adverse events, including in patients receiving their primary series of vaccines, a setting not previously described.
