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Dupilumab Impacts on Children with Atopic Dermatitis Irrespective of TCS, With Alan Irvine, MD
In this interview, improvements observed in children 6-11 years with severe atopic dermatitis following dupilumab use were spotlighted.
At the 2025 European Academy of Dermatology and Venereology (EADV) 2025 Congress in Paris, investigators presented data in a poster titled ‘Growth Improvement in Children 6-11 Years with Severe Atopic Dermatitis Treated with Dupilumab Irrespective of TCS Use.’1,2
These data were highlighted in a recent HCPLive interview with Alan Irvine, MD, professor of dermatology at Trinity College in Dublin, Ireland. Irvine spoke with the editorial team following EADV about his team’s findings on dupilumab in children with severe atopic dermatitis.
“It's an interesting story that we've been working on with Regeneron and Sanofi for about 4 years,” Irvine explained. “So one of the things that I noticed in the 6 to 11 years study, the PEDS AD study, was that there was a higher proportion of kids who had elevated alkaline phosphatase in the treatment arm, as opposed to the placebo arm, in that study. That gave me a clue that something might be happening with their bone metabolism.”
Irvine and colleagues’ enrolled children in this age range into the phase 3, 16-week, placebo-controlled LIBERTY AD PEDS study (NCT03345914).1 Previous analyses from this trial had included 114 individuals and assessed the proportion of those who were below the 30th height percentile at baseline and experienced a ≥5-percentile increase in height after 16 weeks of treatment with dupilumab versus placebo.
In the newer study, the investigators used a standardized topical corticosteroid (TCS) regimen, documenting cumulative TCS utilization as well as the number of TCS-free and inhaled corticosteroid (ICS)-free days throughout the 16-week period of treatment. They also carried out multiple logistic regression analyses, with the primary outcome of the analysis being defined as attainment of a ≥5-percentile gain in height from baseline to the 16-week mark.
“...When we controlled for topical corticosteroid use, that did not influence the effect of the dupilumab versus the placebo arm,” Irvine said. “Because in this trial, people were allowed to use combination therapy with topical corticosteroids. The kids on dupilumab did use less as you'd expect, because their skin was improving with the drug effect, but that didn't explain the difference in their in growth objectives.”
Irvine highlighted his team’s findings on TCS use and the number of treatment-free days, with both appearing to be independent of the impacts of 16 weeks of dupilumab use on increased growth in this 6 - 11-year population versus those on placebo.
Overall, the data indicate that TCS use reductions among those treated with dupilumab may not be contributing to growth increases. They also suggest that any potential negative impacts of TCS use on growth will likely not be counteracted by dupilumab.
For any additional information, view Irvine’s interview segment from EADV above.
The quotes contained in this summary were edited for the purposes of clarity.
Irvine has reported serving as a consultant for AbbVie, Almirall, Arena Pharmaceuticals, BenevolentAI, Chugai Pharmaceutical, Dermavant, Eli Lilly, Genentech, LEO Pharma, Menlo Therapeutics, Novartis, Pfizer, Regeneron Pharmaceuticals Inc, Sanofi, and UCB; as a speaker for AbbVie, Eli Lilly, LEO Pharma, Novartis, Pfizer, Regeneron Pharmaceuticals Inc, and Sanofi; and as an investigator for AbbVie, DS Biopharma, Inflazome, Novartis, Regeneron Pharmaceuticals Inc, and Sanofi.
References
Irvine A, Paller A, Cyr S, et al. Growth Improvement in Children 6 to 11 Years Old with Severe Atopic Dermatitis Treated with Dupilumab Irrespective of TCS Use. Presented at the European Academy of Dermatology and Venereology (EADV) 2025 Congress. Paris, France. September 17-20, 2025.
Blauvelt A, Guttman-Yassky E, Bansal A, et al. Long-Term Efficacy and Safety of Dupilumab in Adolescents with Moderate-to-Severe Atopic Dermatitis: Results Through Week 52 from a Phase III Open-Label Extension Trial (LIBERTY AD PED-OLE). Am J Clin Dermatol. 2022 May;23(3):365-383. doi: 10.1007/s40257-022-00683-2. Epub 2022 May 14. PMID: 35567671; PMCID: PMC9142443.
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