Reduced atopic march risk in pediatric atopic dermatitis patients prescribed dupilumab versus conventional immunomodulatory therapy: A population-based cohort study.
J Am Acad Dermatol
; 91(3): 466-473, 2024 Sep.
Article
em En
| MEDLINE
| ID: mdl-38878041
ABSTRACT
BACKGROUND:
Dupilumab effectively treats atopic dermatitis (AD); however, its role in halting the atopic march remains uncertain.OBJECTIVE:
To investigate dupilumab's effect on atopic march in pediatric AD patients versus conventional immunomodulators.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 11 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.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.LIMITATIONS:
Observational study.CONCLUSION:
Among pediatric AD patients, dupilumab was associated with reduced risk of atopic march progression compared with conventional therapies.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Asma
/
Dermatite Atópica
/
Anticorpos Monoclonais Humanizados
Limite:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Idioma:
En
Revista:
J Am Acad Dermatol
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Taiwan