Dupilumab, topical corticosteroids reduce itch in pediatric patients with AD

Pediatric patients with atopic dermatitis who were treated with dupilumab and topical corticosteroids experienced an improvement in both itch and excoriations, according to a study presentation.

“Severe AD can place a substantial burden on young children aged 6 to 11 years and their families who cope with intense, unrelenting itch and skin lesions. The itch associated with severe AD can be debilitating and impact almost every aspect of these families’ lives, from sleep to school and play. If left untreated, the cycle of itching and scratching may continue to damage the child’s skin, progressing symptoms of cracking, bleeding, crusting and oozing,” study investigator Michael J. Cork, BSc, MB, PhD, FRCP, head of dermatology at Sheffield Dermatology Research and professor of dermatology at University of Sheffield Medical School, told Healio.

The post hoc analysis of the phase 3 double-blind, placebo-controlled, 16-week LIBERTY AD PEDS trial, presented at the virtual European Society for Pediatric Dermatology meeting, included patients aged 6 to 11 years with severe AD who were evaluated for change in itch intensity and frequency.

Of those who were less than 30 kg and received 300 mg Dupixent (dupilumab, Regeneron) every 4 weeks in addition to topical corticosteroids, 54.1% had at least a 4-point improvement in worst itch score on the Numerical Rating Scale compared with 11.7% of those who received only topical corticosteroids. For patients more than 30 kg, 61.4% who received 200 mg dupilumab every 2 weeks plus topical corticosteroids had a 4-point or higher improvement, while 47.5% of those who received 300 mg dupilumab every 4 weeks plus topical corticosteroids and 12.9% of the corticosteroid-only group had the same improvement.

Itch intensity, measured by using SCORing Atopic Dermatitis itch visual analog scale, decreased by 66.6% in the less than 30 kg group that received 300 mg dupilumab every 4 weeks plus topical corticosteroids compared with 8% of the corticosteroid-alone group. The more than 30 kg group that received 200 mg dupilumab every 2 weeks plus topical corticosteroids had a 73.1% decrease, while the 300 mg dupilumab every 4 weeks plus topical corticosteroids group had a 61.5% decrease and the corticosteroid-alone group had a 26.2% decrease.

“The study also showed that at 16 weeks, more than half of children treated with Dupixent plus topical corticosteroids (TCS) experienced a reduction in itch frequency from daily itching to at most 2 days per week compared to just 13% to 16% with TCS alone,” Cork said. “The LIBERTY AD PEDS trial found that Dupixent plus TCS significantly improved overall disease severity, skin clearance and itch in children aged 6 to 11 years with severe AD. This post hoc analysis showed that the clinically meaningful improvements in itch seen in the trial were rapid and sustained, and that improvements were seen in both itch intensity and frequency.”