Effectiveness of Dupilumab for Moderate-to-Severe Atopic Dermatitis in Infants and Young Children:a Retrospective Study

LI Xia; CHEN Ping; XU Xihuan

doi:10.11786/sypfbxzz.1674-1293.20260106

Abstract：Objective To evaluate the clinical effectiveness and safety of dupilumab in the treatment of moderate-to-severe atopic dermatitis(AD)in infants and young children.Methods This single-center retrospective study included 71 infants and young children aged 6 months to 6 years with moderate-to-severe AD treated with dupilumab in the Dermatology Department of the Affiliated Xuzhou Children's Hospital of Xuzhou Medical University from June 2023 to June 2024.Clinical data were collected at baseline and at weeks 4,12,and 16 after treatment initiation.Outcomes included SCORing Atopic Dermatitis(SCORAD),Eczema Area and Severity Index(EASI),itch Numerical Rating Scale(NRS),and age-appropriate quality-of-life scores(Children's Dermatology Life Quality Index[CDLQI]or Infants'Dermatitis Quality of Life Index[IDQoL]).Serum total immunoglobulin E(IgE),peripheral blood eosinophil(EOS)count,and EOS percentage were measured at baseline and week 16.The proportions achieving≥50%,≥75%,and≥90%improvement from baseline in Eczema Area and Severity Index(EASI 50/75/90)at week 16 were calculated.Associations between demographics/clinical characteristics and time to EASI 90 were assessed(Spearman correlation),and factors influencing achievement of EASI 90 at week 16 were evaluated(logistic regression).Adverse events were documented.Results A total of 71 children with AD were included.Compared with baseline,SCORAD,EASI,itch NRS,and CDLQI/IDQoL scores decreased significantly at weeks 4,12,and 16,with marked reductions at week 16(all P<0.05).At week 16,serum total IgE,EOS count,and EOS percentage were also significantly lower than baseline(all P<0.05).The proportions achieving EASI 50,EASI 75,and EASI 90 at week 16 were 97.18%,85.92%,and 52.11%,respectively.Spearman correlation analysis revealed that the time to EASI 90 was positively correlated with baseline disease severity(P<0.05),indicating that more severe disease required longer time to achieve EASI 90.Logistic regression suggested that percentage body surface area(BSA)involvement and age were associated with achieving EASI 90 at week 16(both P<0.05).During treatment,4 children(5.63%)experienced mild adverse events:conjunctivitis(n=2),urticaria(n=1),and transient rash exacerbation(n=1).Conclusion Dupilumab demonstrated effective and safe control over the symptoms and signs of moderate-to-severe AD in infants and young children.Baseline disease severity may influence the time to response,and both BSA involvement and age may be factors influencing its efficacy.