692 - Dupilumab reduces atopic dermatitis lesion severity and extent in children <12 years of age with moderate-to-severe AD: interim results from the PEDISTAD real-world registry

Abstract Introduction/Background In clinical trials, dupilumab has consistently improved disease severity in children with moderate-to-severe atopic dermatitis (AD). Objectives To investigate the impact of systemic treatments on the individual anatomical regions that comprise the Eczema Area and Severity Index (EASI). Methods PEDISTAD (NCT03687359) is an international, longitudinal, observational 10-year registry study of patients aged < 12 years with moderate-to-severe AD. This interim analysis reports mean Eczema Area and Severity Index (EASI) scores of the head and neck and upper limbs at therapy start and last observation. Results A total of 207 patients received dupilumab, 127 received methotrexate and 139 received cyclosporine. The mean observation period was 17.0 months, 18.7 months, and 14.3 months for dupilumab, methotrexate and cyclosporine respectively. Mean (SD) EASI scores for the head and neck area of dupilumab patients improved from 2.0 (0.2) at therapy start to 0.7 (0.1) at last observation. Improvement was also seen in patients receiving methotrexate (therapy start: 2.0 [0.2]; last observation: 1.0 [0.2]) and cyclosporine (therapy start: 2.2 [0.2]; last observation: 1.6 [0.2]. A numerically greater improvement in mean (SD) EASI scores of the upper limbs was observed in patients receiving dupilumab (therapy start: 4.5 [0.2]; last observation: 1.5 [0.2]) than methotrexate (therapy start: 3.8 [0.2]; last observation: 2.1 [0.2]) and cyclosporine (therapy start: 4.1 [0.2]; last observation: 2.9 [0.3]). Adverse events were experienced by 23.7%, 30.5% and 32.6% of patients receiving dupilumab, methotrexate and cyclosporine, respectively. Conclusion Children with moderate-to-severe AD receiving dupilumab, methotrexate, or cyclosporine had improvement in AD lesion severity and extent in individual anatomical regions, with the greatest numerical improvement observed in those receiving dupilumab.