Dupilumab Improves Moderate-to-Severe Atopic Dermatitis in Young Children With Inflammatory Comorbidities

Author(s):

Luke Halpern, Assistant Editor

Key Takeaways

Dupilumab effectively improves atopic dermatitis symptoms in young children, even with comorbid type 2 conditions like asthma and food allergies.
The LIBERTY AD PRESCHOOL trial showed significant improvements in IGA, EASI-75, and WSI-NRS scores with dupilumab treatment.
Dupilumab's safety profile and efficacy make it a promising option for managing AD and potentially preventing other allergic conditions.
Pharmacists should stay informed about evolving treatment guidelines for dupilumab in pediatric atopic dermatitis patients.

Proven effective in the treatment of atopic dermatitis (AD) and other allergic conditions, these study results confirm the ability of dupilumab to improve symptoms in children with other concurrent conditions.

New study results published in the journal Advances in Therapy show that dupilumab (Dupixent; Sanofi, Regeneron) treatment demonstrated improvement in signs and symptoms of atopic dermatitis (AD) in children aged 6 months to 5 years both with and without comorbidities such as food allergies, allergic rhinitis (AR), and asthma.^1,2

close up mother holding kids hands with allergic rash or eczema. severe allergic reaction, atopic skin

If a child develops atopic dermatitis in addition to other inflammatory conditions, it can increase health burdens and reduce quality of life. | Image Credit: © Юля Шевцова | stock.adobe.com

Dupilumab, a fully human monoclonal antibody that inhibits the signaling of both IL-4 and IL-13, has numerous FDA-approved indications, including in patients with uncontrolled chronic spontaneous urticaria and other inflammatory conditions. For AD, it is approved for the treatment of adult and pediatric patients as young as 6 months with moderate-to-severe disease.^1,3,4

Dozens of key clinical trials have indicated significant efficacy and safety in patients with AD treated with dupilumab. However, this new research is the first to analyze the drug’s effectiveness in children with both AD and comorbid type 2 conditions. Using a cohort from the LIBERTY AD PRESCHOOL part B clinical trial, which found that dupilumab and topical corticosteroids improved AD signs, the current investigators sought to evaluate this effectiveness in the presence of comorbidities.^1,2

Efficacy end points included measurements of AD resolution assessed at week 16. Three measurements were used to evaluate the clearing of skin in patients: the Investigator’s Global Assessment (IGA); the Eczema Area and Severity Index (EASI-75); and the Worst Scratch Itch Numeric Rating Scale (WSI-NRS).¹

At the 16-week follow-up point, the investigators found that significantly more patients being treated with dupilumab versus placebo—with or without asthma or AR—had an IGA score of 0 or 1. Furthermore, a much higher number of patients with comorbid food allergies achieved an IGA of 0 or 1.¹

These positive scores continued to be reported. In the EASI, significantly more patients who received dupilumab versus placebo, regardless of the presence of comorbidities, had a 75% or greater improvement in their score. Lastly, a much higher proportion of patients who received dupilumab with or without AR or food allergies had a greater than 4-point reduction in weekly average daily score on the WSI-NRS.¹

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Dupilumab provides a versatile treatment option for the millions of patients burdened with AD and the additional impacts that concurrent type 2 inflammatory conditions can have. Early treatment with the medicine is critical and could potentially offer a strategy for disease alternation by preventing the development of other allergic conditions. The manageable safety profile confirmed in this trial further incentivizes the use of dupilumab in these patients; pharmacists should be aware of evolving treatment guidelines for this patient population.^1,4

“Many children suffer from multiple allergic conditions at the same time, so knowing that dupilumab can be used to safely and effectively treat their atopic dermatitis whether or not they have additional atopic diseases such as asthma or allergies is an important step forward,” Mark Boguniewicz, MD, pediatric allergist and lead author of the study, said in a news release.²

REFERENCES

1. Boguniewicz M, Sher LD, Paller AS, et al. Dupilumab is efficacious in young children with atopic dermatitis regardless of type 2 comorbidities. Adv Ther. 2024;41:4601-4616. doi:10.1007/s12325-024-02998

2. National Jewish Health. Research shows medication effective in treatment of children with atopic dermatitis. EurekAlert! News Release. Released December 4, 2024. Accessed December 18, 2024. https://www.eurekalert.org/news-releases/1067153

3. McGovern G. Pharmacists play crucial role in dupilumab treatment for infants, young children with atopic dermatitis. Pharmacy Times. Published June 12, 2024. Accessed December 18, 2024. https://www.pharmacytimes.com/view/pharmacists-play-crucial-role-in-dupilumab-treatment-for-infants-young-children-with-atopic-dermatitis

4. McGovern G. Dupilumab shows significant reductions in itch and hive activity in patients with CSU. Pharmacy Times. Published November 5, 2024. Accessed December 18, 2024.