A Review of Dupilumab in the Treatment of Atopic Dermatitis in Infants and Children

Abstract

Atopic dermatitis (AD), a common pruritic and chronic inflammatory skin disease, has a major impact on a patient’s quality of life. It is characterized by dry, itchy, and eczema-like rashes. AD is more prevalent in young children and has been linked to a variety of other allergy disorders. Traditional drug therapy has certain limitations for treating young children with AD. However, biologics have good clinical application prospects in the medical treatment of young patients. Dupilumab, a fully human monoclonal antibody, specifically binds to the IL-4 Rα subunit, inhibiting IL-4 and IL-13 signaling and blocking the occurrence of type 2 inflammatory response. It has a good effect on treating infants and children with moderate-to-severe AD. This review explores the safety and efficacy of dupilumab in the treatment of AD in infants and children and the impact of early intervention on AD progression, with the aim of informing clinical practice in the use of dupilumab for the treatment of young patients with AD.

Keywords:

• atopic dermatitis
• dupilumab
• infant
• child
• treatment

Abbreviations

AC, allergic conjunctivitis; AD, atopic dermatitis; CDLQI, Children’s Dermatology Life Quality Index; DCs, dendritic cells; EASI, Eczema Area and Severity Index; EASI-50, at least 50% improvement from baseline in EASI; EASI-75, at least 75% improvement from baseline in EASI; EASI-90, at least 90% improvement from baseline in EASI; FDA, Food and Drug Administration; FLG, filaggrin; IGA, Investigator’s Global Assessment; IGA0/1, Investigator’s Global Assessment score of 0 (clear) or 1 (almost clear); ILC2s, type 2 innate lymphoid cells; JAK, Janus kinase; LOR, loricrin; NRS, Numerical Rating Scale; N/A data not available/reported; QoL, Quality of Life; q4w, every 4 weeks; q2w, every 2 weeks; SCORAD, SCORing Atopic Dermatitis; STAT, signal transducer and activator of transcription; TCS, topical corticosteroids; TEAE, treatment-emergent adverse event; TSLP, thymic stromal lymphopoietin; TWEL, transepidermal water loss.

Ethical Approval

This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

Professor Xing-Hua Gao reports personal fees from advisary, consultation and lecturer for the fllowing roles for Eli Lilly, GSK, Janssen, LEO Pharma, Novartis, Pfizer, Pierre Fabre, Regeneron Pharmaceuticals Inc., Sanofi and, consultancy/advisory board member for AbbVie, Boehringer Ingelheim, Novartis, Pfizer, Sanofi – investigator; AbbVie, AstraZeneca, BMS, Eli Lilly, Huarun, JiaLan, LEO Pharma, Pfizer, Puqi and Sanofi. The authors report no other conflicts of interest in this work.

Additional information

Funding

This work was funded by National Key R&D Program of China (2023YFC2508200) and China Medical Education Association (2023WSJSPGZXKT-14).