Dupilumab's Real-World Efficacy and Safety Across Age Groups for Children and Adolescents With Paediatric Atopic...

Dupilumab is an anti-interleukin (IL)-4 receptor (IL-4Rα) monoclonal antibody used to manage atopic dermatitis (AD). There is a paucity of real-world Australian data for dupilumab in paediatric AD, especially regarding differences in clinical profiles between age groups. This study evaluated dupilumab's efficacy and safety at an Australian tertiary centre.

All paediatric AD patients (< 18 years old) treated with dupilumab at a tertiary centre with available follow-up data were retrospectively analysed. Effectiveness was measured using the Eczema Area and Severity Index (EASI), Children's Dermatology Life Quality Index (cDLQI), and Physician Global Assessment (PGA). Adverse events (AEs) were recorded. Differences in efficacy and safety between age groups (0-5, 6-11, 12-17 years old) were analysed.

103 patients (9.2 ± 3.8 years old, 51.5% male) were analysed with a follow-up of 495.3 ± 337.3 days. 95.1%, 90.1% and 66.7% of patients achieved a 50%, 75%, 90% drop in EASI (EASI-50, EASI-75, EASI-90). 93.4% and 94.7% of patients achieved a 6-point drop in cDLQI and a 2-point drop in PGA. 43.2%, 48.7% and 71.1% of patients achieved EASI ≤ 1, cDLQI ≤ 1 and PGA ≤ 1 respectively. Two patients discontinued dupilumab due to AEs (psoriasis flare and lichenoid drug-reaction). 49 (47.6%) patients experienced AEs, with the most frequent category being ocular-related (n = 43). There were no statistically significant differences between age groups in the rate of achieving efficacy thresholds or in the rate of AEs for each AE category. Median time-to-effect for EASI-50/75/90 were 130, 140 and 291 days on Kaplan-Meier analysis.

Paediatric dupilumab patients experienced significant improvements with an acceptable safety profile, independent of age.