Meaningful amelioration of quality of life in paediatric AD patients on dupilumab

In the phase 3 LIBERTY AD PEDS trial, health-related quality of life in 6 to <12-year-old patients with atopic dermatitis demonstrated significant improvements in the majority of patients treated with dupilumab.

Decreased health-related quality of life (HRQoL) plays an important role for children with atopic dermatitis (AD) and can result in a substantial burden – not only on the patients themselves but also on their parents [1,2].

The phase 3 LIBERTY AD PEDS trial (NCT03345914) investigated the influence of treatment with dupilumab on the HRQoL of children suffering from severe AD [1]. They had all previously failed adequate response to topical treatments. The trial measured HRQoL using the Children’s Dermatology Life Quality Index (CDLQI). This validated questionnaire includes 10 items that can be grouped by domains into sleep, leisure, school/holidays, personal relationships, symptoms and feelings, and treatment as reported by patients and caregivers [3]. LIBERTY AD PEDS enrolled 367 patients between 6 years and <12 years of age [1]. The HRQoL analysis stratified into 4 subgroups: dupilumab 300 mg every 4 weeks plus topical corticosteroids (TCS) in subjects with a body weight <30 kg (group 1), dupilumab 200 mg every 2 weeks plus TCS ≥30 kg (group 2), and 2 groups receiving placebo plus TCS with the same weight distinctions (group 3: <30kg; group 4: ≥30 kg).

At baseline, 80.7–90.2% of patients were at least moderately affected by AD. Statistically significant differences were observed in least square mean change of total CDLQI with a reduction of -6.4 and -6.3 in the placebo groups versus -10.7 (P<0.0001) and -10.4 (P<0.0001) in the dupilumab groups. Similarly, in dupilumab-treated patients, 81.8% and 80.8% achieved an improvement in CDLQI of ≥6 points. At week 16, the great majority of dupilumab treated patients reported no or only a small effect of AD on their HRQoL with 79% in those <30 kg and 82% in group 2. The corresponding values for groups 3 and 4 were 48% and 55%, respectively. The improvements in HRQoL were found in all domains of the questionnaire. Of note, clinically meaningful treatment responses were seen as early as week 2.

1. Irvine AD, et al. Dupilumab improves health-related quality of life in children aged ≥6 to <12 years with severe atopic dermatitis. Poster 27431, AAD VMX 2021, 23-25 April.
2. Beattie PE, Lewis-Jones MS. Br J Dermatol. 2006;155(1):145-51.
3. Lewis-Jones MS, Finlay AY. Br J Dermatol. 1995;132(6):942-9.

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Posted on 7 June 202129 February 2024