Real-World Systemic Treatment Outcomes for Moderate-to-Severe Atopic Dermatitis in Children by Skin Color

BACKGROUNDAtopic dermatitis (AD) can have different genetic, immunopathogenic, and clinical features depending on the ethnicity of the affected individual.

OBJECTIVETo investigate if White and non-White children with moderate-to-severe AD respond differently to systemic treatment.

METHODSPEDISTAD is an observational, international, real-world study. Patients were analyzed in two subgroups: non-White and White. Non-White included Black/African American, Asian, American Indian or Alaskan-Native and Multiracial.

RESULTS314 White, and 186 non-White children <12 years were included. Eczema-area-and-severity -index improved significantly for all: 13.6, 8.2 and 9.2 point-improvement with dupilumab, methotrexate and cyclosporine, respectively (non-White); and 14.2, 10.1 and 4.5 point-improvement (White). Itch scores improved significantly with dupilumab for both subgroups. Cyclosporine was the least effective at reducing itch in this study. Quality-of-life metrics were observed to improve similarly in both groups with dupilumab, to a greater extent than with methotrexate or cyclosporine. The Exposure-adjusted adverse event rate was highest in White children: 33.33, 33.24 and 58.33 events/per 100 person years for dupilumab, methotrexate and cyclosporine respectively, versus 28.28, 20.86 and 28.72 events/per 100 person years in the non-White children.

CONCLUSIONIn this study, patients that received dupilumab had a greater observed improvement in clinician-, and patient-reported outcomes compared with patients receiving methotrexate and cyclosporine irrespective of skin color/race.

Abstract from PubMed