Efficacy, Safety, Quality of Life, and Adherence of Dupilumab in Pediatric Atopic Dermatitis: A Systematic Review.
Jacob Surma, Jenna Currier, David Doyle et al.
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In 30 seconds
This PRISMA-guided systematic review assessed dupilumab efficacy, safety, quality of life, and adherence in children aged 0–12 years with moderate-to-severe atopic dermatitis. It included 20 studies involving around 1200 children, spanning randomised trials and other designs, with narrative synthesis rather than meta-analysis. Across studies, mean Eczema Area and Severity Index scores fell by 62–92%, and 53–94% achieved EASI-75 within 16–52 weeks. Quality of life and sleep generally improved; adverse events were mostly mild, and adherence was high.
Key findings
- Mean EASI reductions were 62–92%, with EASI-75 responses of 53–94% within 16–52 weeks.
- Children's Dermatology Life Quality Index scores fell by up to ~89%, with marked sleep improvement.
- Conjunctivitis was the most common adverse event (0–20%); reported laboratory abnormalities were typically asymptomatic and transient.
- Adherence was ≥90% in most cohorts, with low discontinuation rates.
Why it matters
The review brings together pediatric evidence on disease control, tolerability, quality of life, and treatment adherence, outcomes relevant to weighing systemic therapy for moderate-to-severe disease. Its findings suggest benefits across several domains, while the varied study designs and inconsistent age-group comparisons mean the magnitude and durability of benefit remain uncertain.
What to keep in mind
Evidence was limited by predominantly observational and uncontrolled designs, heterogeneous outcomes and follow-up, and small samples in several cohorts; no meta-analysis was performed.