Dupilumab treatment improves linear growth and bone biomarkers in children with atopic dermatitis: Post hoc analysis of a phase 3 randomized, placebo-controlled clinical trial and an open-label extension study.
Alan D Irvine, Amy S Paller, Elaine C Siegfried et al.
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In 30 seconds
This post hoc analysis of a phase 3 randomized, placebo-controlled trial and its open-label extension examined height and bone alkaline phosphatase (BALP) in children aged 6 to 11 years with severe atopic dermatitis. Children with severe disease were overrepresented in lower height percentiles at baseline. Among children below the 40th height percentile, 31.3% receiving dupilumab achieved a ≥5-percentile height increase by week 16, compared with 15.5% receiving placebo (P < .05); 50.7% of dupilumab-treated children had achieved this by week 52. BALP remained within the normal range and increased with dupilumab.
Key findings
- Among children below the 40th height percentile at baseline, 31.3% on dupilumab versus 15.5% on placebo achieved a ≥5-percentile height increase at week 16 (P < .05).
- By week 52, 50.7% of dupilumab-treated children below the 40th height percentile at baseline had achieved a ≥5-percentile height increase.
- BALP remained within the normal range, was significantly higher with dupilumab than placebo at week 16, and increased further to week 52.
- At week 52, children who switched to dupilumab at week 16 had height and BALP improvements comparable with those treated throughout.
Why it matters
The findings suggest that growth and bone-mineralization biomarkers may improve during dupilumab treatment in children with severe atopic dermatitis, a population in which lower height percentiles were common at baseline. These outcomes broaden the clinical context for assessing disease and treatment in children, while the post hoc analysis and limited follow-up mean the results should be interpreted cautiously.
What to keep in mind
The study had a one-year duration.