Dupilumab in Children and Adolescents with Severe Atopic Dermatitis and Severe Asthma: A Case Series
Source abstract
Abstract
The increasing incidence and common specific inflammatory type 2 intracellular pathways have recently allowed for the rise of new biologic therapies in two inflammatory chronic diseases in children: atopic dermatitis (AD) and severe asthma. Such therapies aim at relieving symptoms and reducing inflammation by treating the underlying molecular causes. Dupilumab is a monoclonal antibody indicated in children with moderate–severe AD and severe asthma ineffectively responsive to standard treatments. Here, we report a case series of seven consecutive children with moderate–severe AD, with three of them also affected by asthma and treated with dupilumab. The children experienced a reduction in the extent and severity of lesions and decreased intensity of symptoms, leading to better asthma control, a general improvement in sleep and quality of life (QoL), with a good safety profile. Notwithstanding the observed clinical improvement, further larger prospective studies are needed to better tailor the treatment duration and the potential preventive and long-lasting effects.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Dermatology and Skin Diseases · Asthma and respiratory diseases · IL-33, ST2, and ILC Pathways
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
Pediatric Allergy and Pulmonology Unit, Department of Pediatrics, University of Chieti, 66100 Chieti, Italy
Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milan, Italy
School of Medicine, University of Enna “Kore”, 94100 Enna, Italy
References (22)
Show source-provided references
1. The global burden of respiratory disease-Impact on child health10.1002/ppul.23030 ↗
2. New insights into the phenotypes of atopic dermatitis linked with allergies and asthma in children: An overview10.1111/cea.13156 ↗
3. GINA (2023, May 01). 2022 Global Initiative for Asthma. Available online: https://ginasthma.org/.
4. Lung function in asthma
5. Asthma endotyping and biomarkers in childhood asthma10.1089/ped.2018.0886 ↗
6. Russo, D., Di Filippo, P., Di Pillo, S., Chiarelli, F., and Attanasi, M. (2023). New Indications of biological drugs in allergic and immunological disorders: Beyond asthma, urticaria, and atopic dermatitis. Biomedicines, 11.10.3390/biomedicines11020236 ↗
7. Biologic therapies for severe asthma10.1056/NEJMra2032506 ↗
8. Role of biologics in asthma10.1164/rccm.201810-1944CI ↗
9. Type 2 inflammation in asthma—present in most, absent in many10.1038/nri3786 ↗
10. Biologics in children with allergic diseases
11. Russo, D., Di Filippo, P., Attanasi, M., Lizzi, M., Di Pillo, S., and Chiarelli, F. (2021). Biologic therapy and severe asthma in children. Biomedicines, 9.10.3390/biomedicines9070760 ↗
12. Metabolic reprogramming mediated by the mtorc2-irf4 signaling axis is essential for macrophage alternative activation10.1016/j.immuni.2016.09.016 ↗
13. Unique functions of the type II interleukin 4 receptor identified in mice lacking the interleukin 13 receptor α1 chain10.1038/ni1544 ↗
14. Dupilumab improves symptoms, quality of life, and productivity in uncontrolled persistent asthma10.1016/j.anai.2018.08.005 ↗
15. Dupilumab efficacy and safety in moderate-to-severe uncontrolled asthma10.1056/NEJMoa1804092 ↗
16. The U.K. Working party’s diagnostic criteria for atopic dermatitis. III. Independent hospital validation10.1111/j.1365-2133.1994.tb08532.x ↗
17. European Task Force on Atopic Dermatitis statement on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and atopic dermatitis10.1111/jdv.16411 ↗
18. Dupilumab-induced hypereosinophilia: Review of the literature and algorithm proposal for clinical management10.1080/17476348.2022.2090342 ↗
19. Dupilumab therapy in atopic dermatitis is safe during COVID-19 infection era: A systematic review and meta-analysis of 1611 patients
20. Dupilumab in children aged 6 months to younger than 6 years with uncontrolled atopic dermatitis: A randomised, double-blind, placebo-controlled, phase 3 trial10.1016/S0140-6736(22)01539-2 ↗
21. Di Filippo, P., Russo, D., Attanasi, M., Di Pillo, S., and Chiarelli, F. (2021). Immunological targets of biologic drugs in allergic skin diseases in children. Biomedicines, 9.10.3390/biomedicines9111615 ↗
22. Attenuating the atopic march: Meta-analysis of the dupilumab atopic dermatitis database for incident allergic events10.1016/j.jaci.2022.08.026 ↗