Pediatric Atopic Dermatitis: Study Suggests Treatment May Impact Atopic March

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<root generator="drupal.xsl" gversion="1.7"> <header> <fileName>168500</fileName> <TBEID>0C050AD3.SIG</TBEID> <TBUniqueIdentifier>MD_0C050AD3</TBUniqueIdentifier> <newsOrJournal>News</newsOrJournal> <publisherName>Frontline Medical Communications</publisherName> <storyname/> <articleType>2</articleType> <TBLocation>QC Done-All Pubs</TBLocation> <QCDate>20240621T120651</QCDate> <firstPublished>20240621T164127</firstPublished> <LastPublished>20240621T164127</LastPublished> <pubStatus qcode="stat:"/> <embargoDate/> <killDate/> <CMSDate>20240621T164127</CMSDate> <articleSource/> <facebookInfo/> <meetingNumber/> <byline>Antara Ghosh</byline> <bylineText>EDITED ANTARA GHOSH</bylineText> <bylineFull>EDITED ANTARA GHOSH</bylineFull> <bylineTitleText/> <USOrGlobal/> <wireDocType/> <newsDocType>News</newsDocType> <journalDocType/> <linkLabel/> <pageRange/> <citation/> <quizID/> <indexIssueDate/> <itemClass qcode="ninat:text"/> <provider qcode="provider:imng"> <name>IMNG Medical Media</name> <rightsInfo> <copyrightHolder> <name>Frontline Medical News</name> </copyrightHolder> <copyrightNotice>Copyright (c) 2015 Frontline Medical News, a Frontline Medical Communications Inc. company. All rights reserved. This material may not be published, broadcast, copied, or otherwise reproduced or distributed without the prior written permission of Frontline Medical Communications Inc.</copyrightNotice> </rightsInfo> </provider> <abstract/> <metaDescription>Pediatric patients with atopic dermatitis (AD) who are prescribed dupilumab may be at a reduced risk for atopic march progression, defined as the development of</metaDescription> <articlePDF/> <teaserImage/> <title>Pediatric Atopic Dermatitis: Study Suggests Treatment May Impact Atopic March</title> <deck/> <disclaimer/> <AuthorList/> <articleURL/> <doi/> <pubMedID/> <publishXMLStatus/> <publishXMLVersion>1</publishXMLVersion> <useEISSN>0</useEISSN> <urgency/> <pubPubdateYear/> <pubPubdateMonth/> <pubPubdateDay/> <pubVolume/> <pubNumber/> <wireChannels/> <primaryCMSID/> <CMSIDs/> <keywords/> <seeAlsos/> <publications_g> <publicationData> <publicationCode>skin</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> </publicationData> <publicationData> <publicationCode>fp</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> </publicationData> <publicationData> <publicationCode>pn</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> </publicationData> <publicationData> <publicationCode>im</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> </publicationData> </publications_g> <publications> <term canonical="true">13</term> <term>15</term> <term>25</term> <term>21</term> </publications> <sections> <term canonical="true">39313</term> <term>27970</term> </sections> <topics> <term canonical="true">189</term> <term>203</term> <term>271</term> <term>188</term> </topics> <links/> </header> <itemSet> <newsItem> <itemMeta> <itemRole>Main</itemRole> <itemClass>text</itemClass> <title>Pediatric Atopic Dermatitis: Study Suggests Treatment May Impact Atopic March</title> <deck/> </itemMeta> <itemContent> <h2>TOPLINE:</h2> <p> <span class="tag metaDescription">Pediatric patients with <a href="https://emedicine.medscape.com/article/1049085-overview">atopic dermatitis</a> (AD) who are prescribed <a href="https://reference.medscape.com/drug/dupixent-dupilumab-1000131">dupilumab</a> may be at a reduced risk for atopic march progression, defined as the development of <a href="https://emedicine.medscape.com/article/296301-overview">asthma</a> or <a href="https://emedicine.medscape.com/article/134825-overview">allergic rhinitis</a>.</span> </p> <h2>METHODOLOGY:</h2> <ul class="body"> <li>Researchers conducted a retrospective cohort study using data from the US Collaborative Network, focusing on pediatric patients aged 18 years and younger with two AD diagnoses at least 30 days apart.</li> <li>Patients were divided into two cohorts: Those treated with dupilumab (n = 2192) and those who received conventional therapies (n = 2192), including systemic corticosteroids or conventional immunomodulators. They were stratified into three age groups: Preschoolers (&lt; 6 years), school-aged children (6 to &lt; 12 years), and adolescents (12-18 years).</li> <li>Both cohorts underwent 1:1 propensity score matching based on current age, age at index (first prescription of dupilumab or conventional therapy), sex, race, comorbidities, laboratory measurements, and prior medications. The primary outcome was atopic march progression, defined by incident asthma or allergic rhinitis.</li> </ul> <h2>TAKEAWAY:</h2> <ul class="body"> <li>Over 3 years, the dupilumab-treated cohort had a significantly lower cumulative incidence of atopic march progression (20.09% vs 27.22%; <em>P</em> &lt; .001), asthma (9.43% vs 14.64%; <em>P </em>= .001), and allergic rhinitis (13.57% vs 20.52%; <em>P</em> = .003) than the conventional therapy cohort.</li> <li>The risk for atopic march progression, asthma, and allergic rhinitis was also significantly reduced by 32%, 40%, and 31%, respectively, in the dupilumab vs conventional therapy cohort.</li> <li>Age-specific analyses found that the protective effect of dupilumab against allergic rhinitis was the most pronounced in adolescents (hazard ratio [HR], 0.503; 95% CI, 0.322-0.784), followed by school-aged children (HR, 0.577; 95% CI, 0.399-0.834), and preschoolers (HR, 0.623; 95% CI, 0.412-0.942).</li> <li>However, dupilumab was associated with reduced risk for asthma only in preschoolers (HR, 0.427; 95% CI, 0.247-0.738) and not in school-aged children or adolescents.</li> </ul> <h2>IN PRACTICE:</h2> <p>“Dupilumab in AD not only treats the disease but may influence atopic march mechanisms, suggesting its role as a disease-modifying atopic march drug,” the authors wrote, adding that more research “with extended follow-up and proof-of-concept is warranted.”</p> <h2>SOURCE:</h2> <p>The study was led by Teng-Li Lin, MD, Department of Dermatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan, and was published <a href="https://www.jaad.org/article/S0190-9622(24)00788-6/abstract">online</a> on June 13, 2024, in the <em>Journal of the American Academy of Dermatology</em>.</p> <h2>LIMITATIONS:</h2> <p>The observational nature of the study limited the ability to infer direct causality between dupilumab use and reduced atopic march risk. Lack of detailed information on AD severity, total dosage, and duration of medication treatment may affect the interpretation of the study’s findings. The demographic data suggest that the dupilumab cohort had more severe AD, so the observed risk reduction may be greater than that reported in this study.</p> <h2>DISCLOSURES:</h2> <p>The study was supported in part by the National Science and Technology Council, Taiwan, and Taichung Veterans General Hospital. The authors had no relevant conflicts of interest.</p> <p> <span class="Emphasis">This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.</span> </p> <p> <em> <span class="Emphasis">A version of this article appeared on </span> <span class="Hyperlink"> <a href="https://www.medscape.com/viewarticle/does-dupilumab-affect-atopic-march-progression-children-2024a1000bd4">Medscape.com</a> </span> <span class="Emphasis">.</span> </em> </p> </itemContent> </newsItem> <newsItem> <itemMeta> <itemRole>teaser</itemRole> <itemClass>text</itemClass> <title/> <deck/> </itemMeta> <itemContent> <ul class="body"> <li>Over 3 years, the dupilumab-treated cohort had a significantly lower cumulative incidence of atopic march progression.</li> </ul> </itemContent> </newsItem> </itemSet></root>