Dupilumab May Improve Growth in Children with Severe Atopic Dermatitis by 16 Weeks

Alan Irvine, MD

Credit: ResearchGate

A study shows a greater percentage of children with atopic dermatitis who were below the 25th percentile in height at baseline experienced an improvement of ≥ 5 percentile points with dupilumab treatment in 16 weeks.¹ The study’s findings will be presented at the 2025 American Academy of Allergy, Asthma, & Immunology (AAAAI) annual meeting in San Diego from February 28 – March 3.

“Data suggests that younger children with more severe [atopic dermatitis] and in lower height percentiles are at risk to remain in lower heigh percentiles as they progress to adolescence if not treated early and effectively,” wrote investigators, led by Alan Irvine, MD, from the school of medicine at Trinity College Dublin, in Ireland.

Conflicting evidence exists on whether atopic dermatitis is linked to a shorter stature. One study showed moderate (95% confidence interval [CI], 1.28 – 3.33; P = .003) and severe (95% CI, 1.17 – 4.48; P = .02) atopic dermatitis was associated with significantly greater odds of having < 25th percentile in height.² The association was nonsignificant for mild atopic dermatitis (P = .95) as well as for < 5 height percentiles.

Investigators sought to characterize the proportion of patients with severe atopic dermatitis who improved≥ 5 percentile points in height after dupilumab treatment, compared with placebo.¹ Their placebo-controlled trial included both children with severe atopic dermatitis (aged 6 – 11 years) and adolescents with moderate-to-severe atopic dermatitis (aged 12 – 17 years). The team collected data on height and weight for each patient and the percentiles were based on Centers for Disease Control and Prevention growth reference charts.

Girls and boys aged 6 – 11 years with atopic dermatitis had a 4.2% and 7.6% greater likelihood of being < the 50th percentile in height, respectively. Adolescents with atopic dermatitis also had a greater likelihood of being < the 50th percentile in height (girls: 4.9%; boys: 10.4%).

A greater portion of children < 25th percentile at baseline improved > 5 percentile points in height after dupilumab treatment compared with placebo. In total, 36.7% of girls on dupilumab increased by > 5 percentile points in height compared with 1.3% of girls on placebo. As for boys, 25% on dupilumab increased > 5 percentile points in height compared with the 5% on placebo.

Not many adolescents achieved a ≥ 5 percentile change in height. Investigators explained this could be because catch-up growth often occurs in children < 12 years.

"Recent studies have reinforced the reduction in height associated with moderate to severe atopic dermatitis,” investigator Amy Paller, MD, from Northwestern University Feinberg School of Medicine, told HCPLive. “It's exciting to see that disease improvement with dupilumab treatment not only improved markers of bone health but also evidence of reversal of the height impairment."

References

1. Irvine, A, Paller, A, Siegfriend, E, et al. GrowthAnalysis in Children Aged 6 to 11 Years and Adolescents Aged 12 to 17 Years with Moderate-To-Severe Atopic Dermatitis and Impact of 16 Weeks of Dupilumab Treatment on Height. Poster will be presented at AAAAI 2025 in San Diego from February 28 – March 3.

2. Silverberg JI, Paller AS. Association Between Eczema and Stature in 9 US Population-Based Studies. JAMA Dermatol. 2015;151(4):401–409. doi:10.1001/jamadermatol.2014.3432