Sleep Quality Improvement in Children Treated with Dupilumab for Atopic Dermatitis

Amy S. Paller, MD

A recent study found that dupilumab treatment and low-potency corticosteroids (TCSs) significantly improved sleep quality for children 6 months to 5 years-old with atopic dermatitis (AD) and their caregivers.

The study, led by Amy S. Paller, MD, Northwestern University Feinberg School of Medicine, sought to examine the effects of dupilumab treatment for younger AD patients.

Paller and colleagues’ overall goal was to “report the impact of 16-week dupilumab treatment on sleep quality in children aged 6 months to 5 years with moderate-to-severe AD inadequately controlled with topical therapies and their caregivers.”

Background and Findings

The investigators recruited patients in the requisite age bracket with moderate-to-severe AD with topical therapies that had been inadequately controlled, randomizing participants 1 to 1.

AD patients included in the study were treated with subcutaneous (SC) dupilumab every 4 weeks. If participants’ baseline weight was ≥ 5 to < 15 kg, they were treated with 200 mg, and they were treated with 300 mg if patients’ weights were ≥ 15 to < 30 kg. Otherwise, they were given a placebo with concomitant low-potency TCS for a total of 16 weeks.

The investigators ranked patients’ sleep quality through an 11-point NRS, with 10 indicating best possible sleep and 0 indicating the worst possible sleep. The parents or caregivers of the participants completed this rating each day.

Both the caregivers’ sleep quality and the younger AD patients’ sleep quality were reported in the investigators’ findings as having substantially improved from baseline following treatment with dupilumab and TCS, compared with the placebo arm of the study.

Also included in the investigators’ research was a set of photos demonstrating visible changes in AD presentation, with the first taken at baseline and the second taken at Week 16.

“A significant improvement in sleep quality was seen as early as 4 weeks after initiation of dupilumab, and continued to improve over 16 weeks, suggesting additional improvement with long-term treatment.”