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

Lin, Teng-Li; Fan, Yi-Hsuan; Fan, Kuo-Sheng; Juan, Chao-Kuei; Chen, Yi-Ju; Wu, Chun-Ying

Lin, Teng-Li; Fan, Yi-Hsuan; Fan, Kuo-Sheng; Juan, Chao-Kuei; Chen, Yi-Ju; Wu, Chun-Ying.

Afiliação

Lin TL; Department of Dermatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan; Ph.D. Program of Interdisciplinary Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Fan YH; Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan.
Fan KS; Division of Chest Medicine, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
Juan CK; Department of Dermatology, Taichung Veterans General Hospital, Taichung, Taiwan.
Chen YJ; Department of Dermatology, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, National Chung-Hsing University, Taichung, Taiwan; Faculty of Medicine and Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. Electronic
Wu CY; Faculty of Medicine and Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan; Division of Translational Research, Taipei Veterans General Hospital, Taipei, Taiwan; Colle

J Am Acad Dermatol ; 2024 Jun 13.

Article em En | MEDLINE | ID: mdl-38878041

ABSTRACT

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.