Effectiveness and safety of dupilumab in the treatment of atopic dermatitis in children (6-11 years): data from a French multicenter 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 to 11, who had received a first dose of dupilumab were included in this multicenter 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

80 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); 3 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 multicenter 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.