BackgroundDupilumab 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.MethodsIn 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.ResultsA 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.ConclusionsTreatment with dupilumab compared to systemic agents resulted in reductions in AD‐related comorbidities in pediatric patients.

中文翻译：

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度普利尤单抗对特应性皮炎儿童和青少年疾病负担的评价：一项基于人群的队列研究


背景Dupilumab 是第一个也是唯一一个被批准用于治疗 6 个月至 17 岁儿科患者特应性皮炎 （AD） 的生物制剂。该研究旨在评估 dupilumab 对 AD 儿科患者合并症发生的影响。方法在这项基于人群的队列研究中，我们利用了来自美国多个医疗保健组织的电子健康记录。诊断为 AD 开始 dupilumab 的儿科患者 （<18 岁） 的倾向评分与开始使用其他全身性药物（硫唑嘌呤、环孢菌素、甲氨蝶呤、吗替麦考酚酯或全身性皮质类固醇）的患者按 1：1 匹配。主要结局是研究期间出现的新发合并症，通过风险比 （risk ratio， RR） 和置信区间 （confidence interval， CI） 衡量。亚组分析按年龄 （0-5 岁、6-11 岁和 12-17 岁）、性别和种族分层。结果共有 3575 例接受 dupilumab 治疗的 AD 儿科患者与 3575 例接受其他全身药物治疗的患者相匹配。度普利尤单抗队列与新发特应性合并症（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（例如皮肤和软组织感染 [RR，0.70;95% CI，0.63-0.76] 和呼吸道感染 [RR = 0.56;95% CI，0.51-0.61]）、精神疾病（例如， 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（例如，注意力缺陷多动障碍 [RR， 0.54;95% CI， 0.38–0.75]）。 此外，发现积极影响在患有 AD 的年幼儿童（0-5 岁）中更为明显。结论与全身性药物治疗相比，度普利尤单抗治疗导致儿科患者 AD 相关合并症减少。