Dupilumab helps prevent atopic march progression in paediatric AD patients

Use of dupilumab effectively lowers the risk of atopic march progression as opposed to conventional immunomodulatory therapies in paediatric patients with atopic dermatitis (AD), reports a recent study. 

Data from the TriNetX US Collaborative Network (2011–2024) was used in this retrospective cohort study. Paediatric AD patients were categorized into the following: dupilumab cohort (newly prescribed dupilumab) or conventional cohort (prescribed conventional immunomodulators without dupilumab). 

Study authors then analysed atopic march progression defined by the incidence asthma or allergic rhinitis (AR), after 1:1 propensity-score matching. They also plotted the cumulative incidence using Kaplan-Meier, with assessment via Cox regression. 

Each cohort included a total of 2,192 patients. At 3 years, the cumulative incidence of atopic march progression was lower in the dupilumab cohort than the conventional cohort (20.09 percent vs 27.22 percent; p<0.001). 

Patients treated with dupilumab had significantly reduced risks of atopic march progression (hazard ratio [HR], 0.68, 95 percent confidence interval [CI], 0.55–0.83), individual asthma (HR, 0.60, 95 percent CI, 0.45–0.81), and individual AR (HR, 0.69, 95 percent CI, 0.54–0.88). 

In addition, younger patients on dupilumab showed a much lower risk reduction for atopic march progression and individual asthma, in contrast to the opposite age-related pattern for individual AR. 

This study was limited by its observational design, according to the authors.