Successful dose reduction of dupilumab in pediatric patients with atopic dermatitis in daily practice: results from the BioDay registry

Background Data on individualized dosing regimens for dupilumab in pediatric atopic dermatitis (AD) are lacking. This study evaluated dose reduction of dupilumab in a pediatric population in daily practice.Research design and methods Pediatric patients (aged <= 16 years) treated with dupilumab were included. Patients with controlled AD were considered eligible for dose reduction. Outcomes included the percentage of (successful) dose reduction and mean Eczema Area and Severity Index (EASI) and Numeric Rating Scale (NRS) pruritus scores over time after initiating dose reduction.Results Of 278 pediatric patients, 126 with controlled disease were eligible for dose reduction (mean age 11.3 years), of whom 65 patients (51.6%) reduced their dupilumab dosage. Reasons for dose reduction included controlled disease only (72.2%), adverse events (AEs) and controlled disease (13.0%), and administration problems and controlled disease (14.8%). At 3 years of treatment, only 13/27 (48.2%) of patients considered eligible for dose reduction remained on their label dosage. Dose reduction was successful in 58 of 65 (89.2%) pediatric patients, with low and stable EASI and NRS pruritus scores.Conclusions Dupilumab dose reduction was successful in the majority of pediatric patients with controlled AD, suggesting that individualized dosing regimens are feasible and may help address practical challenges.