Dupilumab reduces inflammatory biomarkers in pediatric patients with moderate-to-severe atopic dermatitis

Abstract

BackgroundPatients with atopic dermatitis (AD) often have elevated type 2 inflammatory serum biomarkers. ObjectiveTo report changes in thymus- and activation-regulated chemokine (TARC)/CC chemokine ligand 17 (CCL17), total immunoglobulin E (IgE), lactate dehydrogenase (LDH), and eosinophils in pediatric patients treated with dupilumab or placebo. MethodsBiomarker data were analyzed from three randomized, double-blind, placebo-controlled, phase 3 studies of patients with moderate-to-severe AD. Patients aged 6 months–5 years were randomized to weight-dependent dupilumab 200/300mg every 4 weeks (q4w) or placebo; aged 6–11 years to dupilumab 100/200mg every 2 weeks (q2w), dupilumab 300mg q4w, or placebo; aged 12–17 years to dupilumab 200/300mg q2w, dupilumab 300mg q4w, or placebo. The youngest two groups also applied topical corticosteroids. Median percent changes from baseline to week 16 reported using last observation carried forward method, censoring after rescue treatment. ResultsPediatric patients who received dupilumab vs placebo achieved significantly greater median percent reductions at week 16 in: TARC/CCL17 (−83.3% to −72.4% vs −14.9% to −1.8%), total IgE (−71.2% to −58.4% vs −21.0% to +28.1%), and LDH (−26.2% to −9.8% vs −1.5% to +1.5%). All comparisons were significantly different (P < .0001) between each dupilumab dosing group and respective placebo groups. In contrast, absolute changes in eosinophils were small in all groups. ConclusionsDupilumab treatment for pediatric patients with moderate-to-severe AD significantly reduced levels of TARC/CCL17, total IgE, and LDH to levels comparable to those of healthy controls, reflecting a reduction in systemic type 2 and general inflammation.