The Application of Dupilumab to Pediatric Patients Aged 6–11yrs with Moderate-to-Severe Atopic Dermatitis Whose Disease is Not Adequately Controlled: The Clinical Data so Far

Abstract

Background: While dupilumab has shown efficacy in improving atopic dermatitis, few studies have assessed the long-term clinical data of dupilumab use in pediatric patients. Objective: In the present study, we reviewed the current literature to assess reported efficacies, side effects, and risks of using dupilumab to treat atopic dermatitis in pediatric populations. Methods: Using PRISMA guidelines, the authors searched PubMed/MEDLINE and Embase for studies related to dupilumab treatment for atopic dermatitis in pediatric patients aged 6-11 years old. Results: A total of 512 pediatric patients (ages 6-11) were included. Outcome measures assessed by EASI, SCORAD, P-NRS, IGA and C-DLQI showed significant improvements in scores from those observed at baseline to the last treatment of dupilumab. Most reported adverse effects on dupilumab were conjunctivitis and infection site reactions. All studies reported that dupilumab was welltolerated. Limitations: Limitations include the low number of studies available and observation periods of up to 16 weeks, which may be too short to evaluate the drug's effectiveness and occurrence of adverse effects. This also limits our knowledge on whether there are sustained benefits and/or diminished efficacy as well as long-term side effects. Conclusion: Thus far, the data demonstrates dupilumab to be safe and effective in the management of moderate-to-severe atopic dermatitis in children aged 6-11 years. Future studies should evaluate long-term dupilumab use and sustained effects.

Asthma Phenotypes in the Era of Personalized Medicine

“…This dual functionality effectively hinders Type-2-cytokine-driven asthmatic inflamma-tion [172]. Presently, the drug is authorized for managing atopic dermatitis [173][174][175], serving as an add-on maintenance therapy for individuals aged 6 years and older with moderate-to-severe asthma, exhibiting either an eosinophilic phenotype or dependency on OCSs [176,177]. Dupilumab also finds approval for CRSwNP [178,179] and eosinophilic esophagitis (EoE) [180,181].…”

Asthma Phenotypes in the Era of Personalized Medicine

“…This dual activity inhibits type 2 cytokine-driven asthmatic inflammation [148]. The drug is currently approved for the treatment of atopic dermatitis [149][150][151], as an add-on maintenance therapy in patients with moderate-to-severe asthma aged 6 years and older with an eosinophilic phenotype or oral corticosteroid-dependent asthma [152,153], for CRSwNP [154,155] and for eosinophilic esophagitis [156,157]. Clinical trials of dupilumab for asthma demonstrated a reduction in asthmatic exacerbation rates [14], which can be attributed to a very significant improvement in lung function and favorable tolerability with glucocorticoid withdrawal [153,158,159].…”

Exploring Longitudinal Gut Microbiome towards Metabolic Functional Changes Associated in Atopic Dermatitis in Early Childhood

“…AD frequently presents with monotonous eczematous lesions on the face, neck, and skin folds, and it may also present with other features [ 6 , 7 , 8 ]. The clinical trials involving targeted therapies, such as Dupilumab [ 9 , 10 ] and Upadacitinib [ 11 , 12 , 13 ], have previously demonstrated an alleviation of AD symptoms. Over the last decade, numerous studies reported that gut microbiome perturbation during infancy potentially contributes to allergic diseases [ 2 , 14 , 15 , 16 , 17 ].…”