Evaluation of dupilumab on the disease burden in children and adolescents with atopic dermatitis: A population-based cohort study.

IF 12.6 1区医学 Q1 ALLERGY

Allergy Pub Date : 2024-10-01 Epub Date: 2024-08-21 DOI:10.1111/all.16265

Serena Yun-Chen Tsai, Jonathan M Gaffin, Elena B Hawryluk, Hana B Ruran, Lisa M Bartnikas, Michiko K Oyoshi, Lynda C Schneider, Wanda Phipatanakul, Kevin Sheng-Kai Ma

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引用次数: 0

Abstract

Background: Dupilumab is the first and only biologic agent approved for the treatment of atopic dermatitis (AD) in pediatric patients aged from 6 months to 17 years. The study aimed to evaluate the impact of dupilumab on the occurrence of comorbidities in pediatric patients with AD.

Methods: In this population-based cohort study, we utilized electronic health records from multiple healthcare organizations across the United States. Pediatric patients (<18 years of age) with a diagnosis of AD initiating dupilumab were propensity-score matched 1:1 to those initiating other systemic agents (azathioprine, cyclosporine, methotrexate, mycophenolate mofetil, or systemic corticosteroids). The primary outcomes were new-onset comorbidities emerging during the study period measured by the risk ratio (RR) and its confidence interval (CI). Subgroup analyses were stratified by age (0-5 years, 6-11 years, and 12-17 years), sex, and race.

Results: A total of 3575 pediatric patients with AD treated with dupilumab were matched to 3575 patients treated with other systemic agents. The dupilumab cohort was associated with a lowered risk of new-onset atopic comorbidities (including asthma [RR, 0.72; 95% CI, 0.59-0.89] and allergic rhinitis [RR, 0.62; 95% CI, 0.52-0.74]), infections (e.g., skin and soft tissue infection [RR, 0.70; 95% CI, 0.63-0.76] and respiratory tract infection [RR = 0.56; 95% CI, 0.51-0.61]), psychiatric disorders (e.g., mood disorder [RR, 0.52; 95% CI, 0.39-0.70] and anxiety [RR, 0.57; 95% CI, 0.46-0.70], sleep disturbance [RR, 0.60; 95% CI, 0.47-0.77]), neurologic and developmental disorders (e.g., attention deficit hyperactivity disorder [RR, 0.54; 95% CI, 0.38-0.75]). Furthermore, the positive effects are found to be more pronounced in younger children (aged 0-5 years) with AD.

Conclusions: Treatment with dupilumab compared to systemic agents resulted in reductions in AD-related comorbidities in pediatric patients.

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评估杜匹单抗对儿童和青少年特应性皮炎患者疾病负担的影响：基于人群的队列研究

背景介绍杜匹单抗是首个也是唯一一个获准用于治疗特应性皮炎（AD）的生物制剂，适用于6个月至17岁的儿童患者。本研究旨在评估杜匹单抗对儿童特应性皮炎患者合并症发生率的影响：在这项基于人群的队列研究中，我们利用了美国多家医疗机构的电子健康记录。儿科患者共有 3575 名接受杜比单抗治疗的 AD 儿科患者与 3575 名接受其他系统药物治疗的患者进行了配对。dupilumab队列与特应性合并症（包括哮喘[RR，0.72；95% CI，0.59-0.89]和过敏性鼻炎[RR，0.62；95% CI，0.52-0.74]）、感染（如皮肤和软组织感染[RR，0.62；95% CI，0.52-0.74]）的新发风险降低相关、皮肤和软组织感染[RR，0.70；95% CI，0.63-0.76]和呼吸道感染[RR = 0.56；95% CI，0.51-0.61])、精神障碍（例如：情绪障碍[RR，0.52；95% CI，0.52-0.61]）、情绪障碍[RR，0.52；95% CI，0.39-0.70]和焦虑[RR，0.57；95% CI，0.46-0.70]、睡眠障碍[RR，0.60；95% CI，0.47-0.77])、神经和发育障碍（如注意力缺陷多动障碍[RR，0.54；95% CI，0.38-0.75]）。此外，在年龄较小（0-5岁）的AD患儿中，积极效果更为明显：结论：与全身用药相比，使用dupilumab治疗可减少儿童患者的AD相关并发症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Allergy 医学-过敏

CiteScore

26.10

自引率

9.70%

发文量

393

审稿时长

2 months

期刊介绍： Allergy is an international and multidisciplinary journal that aims to advance, impact, and communicate all aspects of the discipline of Allergy/Immunology. It publishes original articles, reviews, position papers, guidelines, editorials, news and commentaries, letters to the editors, and correspondences. The journal accepts articles based on their scientific merit and quality. Allergy seeks to maintain contact between basic and clinical Allergy/Immunology and encourages contributions from contributors and readers from all countries. In addition to its publication, Allergy also provides abstracting and indexing information. Some of the databases that include Allergy abstracts are Abstracts on Hygiene & Communicable Disease, Academic Search Alumni Edition, AgBiotech News & Information, AGRICOLA Database, Biological Abstracts, PubMed Dietary Supplement Subset, and Global Health, among others.