D1.380 - Quicker EASI 75 or greater decline of DLQI - is it significant? Comparison of dupilumab treatment among children and adults in two centres in Cracow

Atopic dermatitis (AD) is a chronic, recurrent skin condition characterized by dryness, itching and exematous skin lesions, caused by immune dysfunction. It affects up to 20% of children and 2-5% of adults. Moderate-to-severe AD, negatively impacting quality of life (QoL), is an indication for systemic therapy. Biologic therapies, including dupilumab, showed considerable promise for patients unresponsive to conventional treatments. This study evaluated the real-life efficacy of these biologics among children and adults with AD.

This study prospectively enrolled severe AD patients (aged ≥6 years) at University Children’s Hospital and Żeromski Specialist Hospital, Kraków, Poland. We included patients with AD diagnosis refractory to systemic therapies and phototherapy. Disease severity and treatment efficacy were evaluated and compared between children and adult population using the Eczema Area and Severity Index (EASI), and QoL metrics, including the Dermatology Life Quality Index (DLQI) for patients ≥18 and Children Dermatology Life Quality Index (CDLQI) for patients 6-18 years old at baseline, 16 weeks, and 3 times every 3 months.

A total of 45 patients were enrolled, 31 children and 14 adults. We found no significant differences in baseline EASI level between studied group. After achieving 1^st control point, median EASI values oscillated between 2.5 to 3.4 in children sample, whereas in adult between 1.2 to 4.5. The differences between children and adults at all control points were non-significant (Fig1). EASI 75 was achieved by 77% of children and 64% of adults at 1^st control point, whereas by all patients at 3^rd one. EASI 90 was achieved by 48% of children and 43% of adults at 1^st control point, whereas at 3^rd one by 55% of children and 79% of adults.

DLQI was statistically significantly higher in adult than in children sample (mean: 22.9 vs 17.1 (p=0.003)). Mean DLQI or CDLQI from 1^st to 4^th control point were significantly lower than at baseline (p<0.001), however we observed that adults achieved greater decline of DLQI, and these differences were statistically significant (p<0.001), although each measure exceeding the minimal clinically important difference.

Dupilumab demonstrated significant efficacy in reducing disease severity and improving QoL in pediatric and adult patients with AD. These positive changes in effectiveness outcomes were maintained or further improved since treatment initiation.