Background: Dupilumab is licenced for treatment of moderate-to-severe atopic dermatitis (AD) in patients six months of age or more.
Objectives: The aim of this study was to examine real-world outcomes and safety of dupilumab for British children with moderate to severe AD attending a tertiary referral paediatric centre.
Methods: Skin and quality of life scores, adverse events and discontinuation rates were assessed. Patients ≤18 years old with moderate-to-severe AD were included if they had skin scores recorded at baseline and at least one follow-up visit. Efficacy and safety were assessed using descriptive statistics.
Results: 72 children/teenagers aged 7-18 (median 14) years old were included in this retrospective observational survey. Oral systemic immunosuppressants had failed to control AD in 88% of children recruited. All patients commenced on dupilumab had pre-treatment skin scores consistent with moderate-to-severe disease (median (range) EASI 25 (20-31)). EASI scores decreased by 94% (82% - 100%) and remained consistently low over 10 to 52 months of the study, with an EASI scores at final follow-up of 2 (0-6). 11% of children were able to discontinue dupilumab because of disease remission. 19 (26%) had adverse events, most commonly conjunctivitis (12 patients, 17%). Eight (11%) discontinued dupilumab (six with ongoing inflammatory skin flares, one with severe allergic conjunctivitis, one with intercurrent Wilson disease).
Conclusion: Dupilumab was highly effective in treating most children with moderate-to-severe AD with good safety outcomes in the real world. However, 10% of children may need alternative therapy because of drug ineffectiveness or side-effects.
© The Author(s) 2024. Published by Oxford University Press on behalf of British Association of Dermatologists.