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Reduced atopic march risk in pediatric atopic dermatitis patients prescribed dupilumab versus conventional immunomodulatory therapy: A population-based cohort study.

Authors :
Lin TL
Fan YH
Fan KS
Juan CK
Chen YJ
Wu CY
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.)

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