Dupilumab Improves Clinical Scores in Children and Adolescents With Moderate to Severe Atopic Dermatitis: A Real-World, Single-Center Study

J Allergy Clin Immunol Pract. 2022 Sep;10(9):2378-2385. doi: 10.1016/j.jaip.2022.06.014. Epub 2022 Jun 24.


Background: Dupilumab has proven safe and effective in children and adolescents with atopic dermatitis (AD) in clinical trials. However, comprehensive real-world studies in the pediatric AD population are still needed.

Objective: To characterize the long-term treatment responses and adverse events of dupilumab-treated children and adolescents with AD during dermatology follow-up assessments.

Methods: We reviewed electronic medical records from March 2017 to September 2021 of moderate to severe AD patients starting dupilumab at less than age 18 years. Demographics, AD scores (body surface area [BSA], Eczema Area and Severity Index [EASI], and Investigator's Global Assessment [IGA]) as well as safety data were collected.

Results: A total of 89 patients, 50 females (56.2%) and 39 males (43.8%), were included. Mean ± SD treatment duration was 1.3 ± 0.9 years. Of these, 73 had score assessments at baseline and weeks 12 to 24. Mean ± SD improvements in BSA, EASI, and IGA were 63.1% ± 29.2%, 39.6% ± 29.9%, and 59.6% ± 30.7%, respectively. All patients (n = 23) who received dupilumab for 1 year or more achieved 75% improvement in EASI and IGA 0/1, and 60.8% achieved 90% improvement in EASI. Positive history of atopy was associated with greater percent improvement in BSA at weeks 12 to 24 (P < .05). Twelve patients had adverse events (13.5%), of which conjunctivitis (5.6%) and joint pain (2.2%) were most common. There were no serious adverse events.

Conclusions: Dupilumab was well-tolerated and effective in treating pediatric and adolescent AD regardless of age, sex, race, or ethnicity.

Keywords: Adolescents; Adverse events; Atopic dermatitis; Children; Dupilumab efficacy; Dupilumab safety; Immunomodulatory therapy; Pediatric; Real-world data; Retrospective study.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Antibodies, Monoclonal, Humanized
  • Child
  • Dermatitis, Atopic* / drug therapy
  • Double-Blind Method
  • Female
  • Humans
  • Hyperplasia
  • Immunoglobulin A
  • Injections, Subcutaneous
  • Male
  • Severity of Illness Index
  • Treatment Outcome


  • Antibodies, Monoclonal, Humanized
  • Immunoglobulin A
  • dupilumab