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Title: Dupilumab is Efficacious in Young Children with Atopic Dermatitis Regardless of Type 2 Comorbidities.
Author: Boguniewicz M, Sher LD, Paller AS, Arkwright PD, Yoshihara S, Chen Z, Shah P, Marco AR.
Journal: Adv Ther; 2024 Dec; 41(12):4601-4616. PubMed ID: 39470878.
Abstract:
INTRODUCTION: Patients with atopic dermatitis (AD) often have other comorbid type 2 inflammatory conditions. The aim of this study was to evaluate the impact of type 2 comorbidities on the response to and safety of dupilumab in young children with AD. METHODS: LIBERTY AD PRESCHOOL part B was a randomized, placebo-controlled trial in children aged 6 months to 5 years with moderate-to-severe AD. In this post hoc analysis, patients were stratified by the presence or absence of caregiver-reported selected type 2 comorbidities at baseline: asthma, allergic rhinitis (AR), and food allergies (FAs). RESULTS: At week 16, significantly more patients receiving dupilumab versus placebo, with or without asthma and AR, achieved an Investigator's Global Assessment (IGA) score of 0/1 and a ≥ 75% improvement in Eczema Area and Severity Index (all p < 0.05). Significantly more patients receiving dupilumab versus placebo with FAs and numerically more patients without FAs achieved an IGA score of 0/1 (p = 0.0007 and p = 0.06). Numerically more patients receiving dupilumab versus placebo with asthma and significantly more patients without asthma achieved a ≥ 4-point reduction in the weekly average of daily score on the Worst Scratch/Itch Numeric Rating Scale (WSI-NRS) (p = 0.6 and p < 0.0001). Additionally, significantly more patients receiving dupilumab versus placebo with or without AR (p = 0.008 and p < 0.0001) and with or without FAs (p = 0.0002 and p = 0.004) achieved a ≥ 4-point reduction in the weekly average of daily score on the WSI-NRS. Overall safety was consistent with the known dupilumab safety profile. CONCLUSIONS: Dupilumab treatment improves AD signs and symptoms in children aged 6 months to 5 years with and without type 2 comorbidities such as asthma, AR, and FAs. TRIAL REGISTRATION: ClinicalTrials.gov registration number NCT03346434. INFOGRAPHIC: Do type 2 comorbidities impact the response to dupilumab in children with atopic dermatitis? (MP4 103,451 KB). Patients with atopic dermatitis (AD; also known as eczema) often have other inflammatory conditions as well, including asthma, allergic rhinitis, and food allergies. Like AD, they are all so-called type 2 conditions, caused by similar processes in the body. A drug called dupilumab has been shown to be effective in treating patients with moderate-to-severe AD. This study looked at the results of a clinical trial in which children aged 6 months to 5 years with moderate-to-severe AD had been treated with either dupilumab or placebo for 16 weeks. The trial results had already shown that at the end of the study, dupilumab compared with placebo resulted in better improvements in their disease and quality of life. In this study, we looked at patients who had only AD, and those who had AD plus one of the other type 2 conditions. We wanted to know if the conditions would impact the response to dupilumab in children with AD. Results showed that dupilumab was better than placebo at reducing the signs and the symptoms of AD in patients, whether or not they also had asthma, allergic rhinitis, or food allergies. Overall safety was consistent with the known dupilumab safety profile. In summary, dupilumab improves the signs and symptoms of moderate-to-severe AD in children aged 6 months to 5 years whether or not they also have another type 2 condition. These results suggest that dupilumab treatment may be effective in children with or without other type 2 conditions.

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