Prospective observation study of the effect of dupilumab on the body weight of children with atopic dermatitis

BACKGROUND: Dupilumab is a drug from the group of biological therapy approved for use in children from 6 years of age in Russian Federation. Due to the recent introduction into clinical practice, appear new reports about various clinical effects that may be associated with the use of the drug, but are not listed in the instructions. Thus, cases of the possible effect of dupilumab on weight gain in adult patients with atopic dermatitis have been reported. We recorded a weight change greater than the average weight gain in children treated with dupilumab.

AIM: The aim of the study was to evaluate the change in the weight of patients with moderate to severe atopic dermatitis treated with dupilumab for a year.

MATERIALS AND METHODS: From January to December 2022 28 children with moderate and severe atopic dermatitis were under observation. All patients were treated with dupilumab in accordance with clinical guidelines for the treatment of atopic dermatitis. Before and at the end of the study, patients were assessed for the severity of the disease, height, body weight, the body mass index, as well as a survey about the quality of sleep and compliance with a hypoallergenic diet. Patients were divided into 2 age groups: 6–10 years old and 11–13 years old. The results of measurements were evaluated separately in each age group and were correlated with centile tables.

RESULTS: The study included 28 patients aged 6 to 13 years [18 girls (64.3%) and 10 boys (35.7%), mean age 10.25 years] with moderate (n = 11; 39.3%) and severe (n = 17; 60.7%) course of atopic dermatitis (mean SCORAD 57.3 ± 4.6). At the end of the observation period, weight gain in the first age group was 5.8 kg; in the second group — 3.06 kg; while the body mass index increased in the first age group by 1.65; in the second group — by 0.23. According to the results of the survey at the initiation stage 19 (67.86%) participants in the observational program noted the presence of sleep disorders, 17 (60.71%) patients followed a hypoallergenic diet. At the end of the observation period 15/19 (78.94%) patients noted an improvement in the quality of sleep, 12/17 (70.59%) patients indicated an increase in the diet.

CONCLUSIONS: The first data on a probable association between the treatment of atopic dermatitis with dupilumab and weight gain in the pediatric population are presented. The exact mechanism of the drug effect on weight gain is not clear, but the positive effect is to expand the diet, normalize sleep and improve the psychological background, which leads to an increase in body weight in relation to its initial shortage.