Paller Amy S, Ramien Michele, Cork Michael J, Simpson Eric L, Wine Lee Lara, Eichenfield Lawrence F, Khokhar Faisal A, Coleman Anna, Gherardi Guy, Chen Zhen, Zhang Annie, Cyr Sonya L
Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Ann and Robert H. Lurie Children's Hospital, Chicago, Illinois, USA.
Pediatr Dermatol. 2025 Mar-Apr;42(2):251-258. doi: 10.1111/pde.15781. Epub 2024 Nov 11.
To evaluate long-term infection rates in children aged 6 months to 5 years with moderate-to-severe atopic dermatitis (AD) treated with dupilumab.
This was a post hoc analysis of an ongoing open-label extension (OLE) study of dupilumab. Pediatric patients aged 6 months to 5 years with moderate-to-severe AD who had previously taken part in the LIBERTY AD PRESCHOOL phase 2 and 3 clinical trials received weight-based subcutaneous dupilumab every 2 or 4 weeks. Exposure-adjusted infection rates after a median dupilumab exposure of 52 weeks are compared with data from the earlier randomized, placebo-controlled, 16-week LIBERTY AD PRESCHOOL phase 3 trial.
Infection rates were overall lower in the OLE study compared with the dupilumab and placebo groups in the earlier 16-week trial, including total infections (101.0 patients/100 patient-years [PY]), nonherpetic skin infections (22.7 patients/100PY), herpetic infections (7.3 patients/100PY), and nonskin infections (92.9 patients/100PY). The frequency of severe and serious infections was low (3.1 patients/100PY), compared with 17.1 placebo-treated patients/100PY and 0 dupilumab-treated patients in the earlier 16-week trial, and no infections leading to treatment discontinuation were observed. Systemic anti-infective medication use (58.9 patients/100PY) was lower in the OLE study compared with both the dupilumab and placebo groups in the 16-week trial.
Overall, reduced infection rates are observed in infants and young children with moderate-to-severe AD treated with dupilumab long-term, supporting the known safety profile of dupilumab.
评估使用度普利尤单抗治疗的6个月至5岁中度至重度特应性皮炎(AD)患儿的长期感染率。
这是一项正在进行的度普利尤单抗开放标签扩展(OLE)研究的事后分析。曾参与LIBERTY AD PRESCHOOL 2期和3期临床试验的6个月至5岁中度至重度AD儿科患者,每2或4周接受一次基于体重的皮下注射度普利尤单抗。将度普利尤单抗中位暴露52周后的暴露调整感染率与早期随机、安慰剂对照、为期16周的LIBERTY AD PRESCHOOL 3期试验的数据进行比较。
与早期16周试验中的度普利尤单抗组和安慰剂组相比,OLE研究中的感染率总体较低,包括总感染(101.0例患者/100患者年[PY])、非疱疹性皮肤感染(22.7例患者/100PY)、疱疹性感染(7.3例患者/100PY)和非皮肤感染(92.9例患者/100PY)。严重和重度感染的发生率较低(3.1例患者/100PY),而在早期16周试验中,安慰剂治疗组为17.1例患者/100PY,度普利尤单抗治疗组为0例患者/100PY,且未观察到导致治疗中断的感染。与16周试验中的度普利尤单抗组和安慰剂组相比,OLE研究中全身抗感染药物的使用(58.9例患者/100PY)较低。
总体而言,长期使用度普利尤单抗治疗的中度至重度AD婴幼儿的感染率降低,这支持了度普利尤单抗已知的安全性。