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Reduced atopic march risk in pediatric atopic dermatitis patients prescribed dupilumab versus conventional immunomodulatory therapy: A population-based cohort study.
- Source :
-
Journal of the American Academy of Dermatology [J Am Acad Dermatol] 2024 Sep; Vol. 91 (3), pp. 466-473. Date of Electronic Publication: 2024 Jun 14. - Publication Year :
- 2024
-
Abstract
- Background: Dupilumab effectively treats atopic dermatitis (AD); however, its role in halting the atopic march remains uncertain.<br />Objective: To investigate dupilumab's effect on atopic march in pediatric AD patients versus conventional immunomodulators.<br />Methods: This retrospective cohort study utilized data from the TriNetX US Collaborative Network (2011-2024). Pediatric AD patients (≤18 years) were categorized into DUPI-cohort (newly prescribed dupilumab) or CONV-cohort (prescribed conventional immunomodulators without dupilumab). After 1:1 propensity-score matching, we analyzed atopic march progression, defined by the incident asthma or allergic rhinitis (AR). Cumulative incidence was plotted using Kaplan-Meier, with risk assessment via Cox regression.<br />Results: The study included 2192 patients in each cohort. The 3-year cumulative incidence of atopic march progression was lower in the DUPI-cohort than the CONV-cohort (20.09% vs 27.22%; P < .001). The DUPI-cohort demonstrated significant risk reduction in atopic march progression (hazard ratio [HR] 0.68, 95% CI 0.55-0.83), individual asthma (HR 0.60, 0.45-0.81), and individual AR (HR 0.69, 0.54-0.88). Younger patients on dupilumab exhibited a greater risk reduction for atopic march progression and individual asthma, contrasting with the opposite age-related pattern for individual AR.<br />Limitations: Observational study.<br />Conclusion: Among pediatric AD patients, dupilumab was associated with reduced risk of atopic march progression compared with conventional therapies.<br />Competing Interests: Conflicts of interest None declared.<br /> (Copyright © 2024 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Humans
Male
Child
Female
Retrospective Studies
Child, Preschool
Adolescent
Immunologic Factors therapeutic use
Rhinitis, Allergic drug therapy
Rhinitis, Allergic epidemiology
Incidence
Infant
Disease Progression
Risk Assessment statistics & numerical data
Propensity Score
Cohort Studies
Dermatitis, Atopic drug therapy
Dermatitis, Atopic epidemiology
Antibodies, Monoclonal, Humanized therapeutic use
Asthma drug therapy
Asthma epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6787
- Volume :
- 91
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of the American Academy of Dermatology
- Publication Type :
- Academic Journal
- Accession number :
- 38878041
- Full Text :
- https://doi.org/10.1016/j.jaad.2024.05.029