Dupilumab Tx supports growth in pediatric patients with severe AD

Photo by Eisfelder via Wikimedia Commons

New research has documented a significant impact of severe atopic dermatitis (AD) on a child’s height, and that dupilumab treatment can help improve growth.

The study, published in the Journal of the American Academy of Dermatology, investigated the effect of a medication commonly used to treat AD on growth and bone biomarkers in 123 children aged six to 11 years with severe eczema.

Researchers found that children who had severe AD and growth restriction and were treated with the biologic dupilumab grew more than those with similar AD and growth restriction who did not receive the treatment. The findings suggest that early, effective treatment of children with severe AD could have lifelong implications for a child’s growth. 

The research was undertaken by Alan Irvine, Professor of Dermatology in Trinity College Dublin’s School of Medicine, in collaboration with researchers from Regeneron and Sanofi. These companies had conducted clinical trials of dupilumab for AD.

Analyzing data from the original clinical trial, the team found that children who had severe AD were, on average, shorter than population norms. 

When researchers tracked their growth through the clinical trials, it was clear that those most growth-restricted benefited greatly from dupilumab treatment, with significant increases in height over the first 16 weeks of the trial. 

After 16 weeks, the group that had been given placebo were switched to dupilumab, and they too rapidly caught up in growth. Blood markers that measure new bone growth also reflected normal growth. 

“Eczema (AD) is the commonest skin disorder in children worldwide. It is typically an itchy and painful rash that interferes with sleep and has a very significant impact on quality of life in affected children,” said Professor Irvine, in a press release from Trinity. 

“Children who live with severe eczema often have delayed growth that is poorly understood but is thought to be due to a combination of factors including the energy needed to maintain inflammation, sleep disruption, and possibly the effects of steroid treatments for the condition.”  

“These findings are good news for children living with eczema. Effective treatment of eczema not only improves the skin, but it may also help children grow at a more normal rate and support healthy bone development.”

“We don’t yet know what is behind this improved growth rate. It may be that reducing chronic inflammation helps the body grow, or it may be because better sleep, thanks to improved itch, supports growth. Further research is needed to understand the mechanisms at play.”