Dupilumab, steroid combination may improve atopic dermatitis in children
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A regimen of dupilumab and a corticosteroid may be beneficial for preteen children with severe atopic dermatitis, according to findings presented at the American Academy of Dermatology virtual meeting.
“Dupilumab is a human monoclonal antibody that blocks the shared receptor component for interleukin-4 and interleukin-13,” Amy S. Paller, MD, FAAD, of Northwestern University Feinberg School of Medicine, said in the presentation. “These are thought to be critical drivers of type 2 inflammation in not just atopic dermatitis, but the wide variety of other atopic disorders.”
Paller and colleagues analyzed data from a double-masked trial of 367 children between 6 and 12 years of age with severe AD based on an Investigator’s Global Assessment score of 4. The patients were randomly assigned to receive dupilumab every 2 weeks based on weight (100 mg for children below 30 kg, 200 mg for children 30 kg or above), dupilumab 300 mg every 4 weeks regardless of weight or placebo during a period of 16 weeks.
After 2 weeks, the patients were treated with medium-potency topical corticosteroids.
At the 16-week mark, IGA scores of 0 or 1 were achieved in 29.5% of the group that received dupilumab every 2 weeks, 32.8% of the group that received dupilumab every 4 weeks and 11.4% of the placebo group. The two dupilumab groups achieved a greater Eczema Area Severity Index-75 score compared with the placebo group (67.2% in the every 2 weeks group and 69.7% in the every 4 weeks group vs. 26.8% in the placebo group).
The least squares mean percent change was –78.4 for the every 2 weeks group, –82.1 for the every 4 weeks group and –48.6 for the placebo group (P < .001) for EASI and –57, –54.6 and –25.9, respectively, (P < .001) for Peak Pruritus Numerical Rating Scale.
Serious adverse events were rare. There was a greater occurrence of injection site reactions and conjunctivitis in the dupilumab groups compared with the placebo group.
“Dupilumab and steroid was well tolerated, and data were consistent with the known dupilumab safety profile observed in adults and adolescents,” Paller said.
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