Dupilumab Shows Sustained Effectiveness Through 3 Years in Pediatric Atopic Dermatitis: Analysis
Key Takeaways
- A prospective cohort of more than 300 pediatric patients with moderate to severe atopic dermatitis showed improvement with dupilumab that was sustained during follow-up extending to 3 years.
- Three-year dupilumab drug survival was 80.1%; 16.2% of patients discontinued treatment, most commonly because of ineffectiveness, adverse events, or administration problems.
- Ocular surface disease was the most frequently reported adverse event (36.6% of the cohort); younger children had greater pruritus and quality-of-life impairment over time.
Dupilumab demonstrated sustained effectiveness and a 3-year drug survival rate of 80.1% among pediatric patients with moderate to severe atopic dermatitis (AD) in a prospective real-world cohort published in JAMA Dermatology.
The multicenter BioDay Registry study included 309 patients aged 16 years or younger who initiated dupilumab at 4 academic and 3 nonacademic hospitals in the Netherlands between 2019 and 2025. Mean patient age was 10.2 years, and the cohort included 51 children aged 6 months to 5 years, 120 aged 6 to 11 years, and 138 aged 12 to 16 years. Investigators used the Eczema Area and Severity Index (EASI) and Investigator Global Assessment to assess outcomes, along with patient-reported measures of pruritus, pain, and quality of life.
Dupilumab Maintains Atopic Dermatitis Control for Up to 3 Years
Most patients maintained controlled AD during follow-up. At 3 years, mean EASI was 3.4 (95% CI, 2.4 to 4.5), while mean pruritus Numeric Rating Scale score was 3.6 (95% CI, 3.1 to 4.1). Children aged 6 months to 5 years consistently had higher pruritus and quality-of-life scores than older children.
Dupilumab-associated ocular surface disease was the most frequently reported adverse event (113 patients [36.6%]). Overall, 50 patients (16.2%) discontinued treatment, including 19 because of ineffectiveness, 15 because of adverse events, and 11 because of administration problems. Most discontinuations occurred within 1.5 years.
Study limitations included the observational study design and differences in follow-up duration among age groups.
“The results of this cohort study suggest that dupilumab demonstrates long-term effectiveness and safety in pediatric AD in a clinical setting,” the authors wrote. “Younger children show higher NRS scores for pruritus and greater QoL impairment and discontinue treatment more often due to administration problems, highlighting age-specific challenges.”
Source
Vroman F, et al. JAMA Dermatology. 2026. Doi:10.1001/jamadermatol.2026.3548