Dupilumab associated with reduced risk for atopic march progression

Key takeaways:

• 3-year cumulative incidence of atopic march progression was lower in the dupilumab vs. conventional therapy group (20.09% vs. 27.22%).
• The risk for asthma and allergic rhinitis was also significantly reduced.

Dupilumab treatment was associated with the reduced risk for atopic march progression in pediatric and adolescent patients with atopic dermatitis, according to a study.

“Dupilumab, a monoclonal antibody targeting [interleukin]-4 receptor alpha, shows promise in treating AD,” Teng-Li Lin, MD, of the department of dermatology at Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation in Chiayi, Taiwan, and colleagues wrote. “It addresses allergic inflammation and reverses epidermal abnormalities all linked to atopic march risk.”

In this retrospective cohort study, researchers analyzed the impact of dupilumab on atopic march progression in AD by comparing pediatric patients newly treated with dupilumab (n = 2,192) and pediatric patients treated with conventional therapies (n = 2,192).

Results showed that the 3-year cumulative incidence of atopic march progression was lower in the dupilumab group vs. the conventional therapy group (20.09% vs. 27.22%; P < .001). The risk for atopic march progression was significantly reduced among those treated with dupilumab compared with those treated with conventional therapies (HR = 0.68; 95% CI, 0.55-0.83).

Additionally, the cohort treated with dupilumab experienced reduced risk in developing asthma (HR = 0.6; 95% CI, 0.45-0.81) and allergic rhinitis (HR = 0.69; 95% CI, 0.54-0.88).

Over the span of 3 years, patients treated with dupilumab had significantly lower risks for atopic march progression across age groups, including in preschoolers (HR = 0.537; 95% CI, 0.381-0.756), school-aged children (HR = 0.635; 95% CI, 0.466-0.865) and adolescents (HR = 0.639; 95% CI, 0.44-0.927). Similar findings were observed concerning the risk for allergic rhinitis; however, there were differences between age groups regarding asthma with only preschool-aged children experiencing a decreased risk for asthma development (HR = 0.427; 95% CI, 0.247-0.738) vs. school-aged children and adolescents.

The researchers called the study’s observational design a limitation.

Overall, the authors concluded that pediatric patients with AD that were prescribed dupilumab experienced a decreased risk for atopic march progression compared with those prescribed conventional therapies.

“Further research with extended follow-up and proof-of-concept is warranted,” the authors wrote.