Eczema (or atopic dermatitis) affects millions of people, especially children under the age of six.
The chronic inflammatory skin disorder causes the skin to turn red and dry and start to ooze and itch, which makes life very uncomfortable.
There is currently no cure for the condition, just ways to manage it – but an existing drug is incredibly effective in reducing the signs and symptoms of eczema in children under six with moderate to severe cases of the disease.
This is the first time that a complex biological drug like this has been tested on this age group.
The drug in question is dupilumab. In a new study, 162 North American and European children aged 6 months to 6 years with moderate to severe eczema were given dupilumab or a placebo for 16 weeks.
More than half of the children given the drug showed a 75% reduction in symptom severity. The itching was significantly reduced and the children were able to sleep much better.
“Preschoolers who scratch constantly, wake up several times a night with their parents, are irritable, and markedly reduced in their ability to do what other children their age can do, improve to the extent that they sleep through the night, change personalities, and have a normal life — just like babies and children should,” says dermatologist Amy Paller of Northwestern University in Illinois.
Dupilumab targets an important immune inflammation pathway in allergies and is already used to treat eczema in older children and adults, as well as asthma, nasal polyps and other allergy-related issues.
Until now, it hasn’t been approved as safe or confirmed to be effective for those under the age of six – around 19% of this demographic have eczema, while 85-90% of those who develop eczema eczema in their lives see the first signs before the age of five.
About a third of this age group with eczema has a moderate to severe case of the disease, accompanied by debilitating itching: these children cannot sleep properly, which has all sorts of effects and consequences.
While immunosuppressive drugs such as oral steroids are often used for severe cases of eczema, there are concerns about their suitability for young children, both in terms of short-term side effects and long-term health complications, according to Pall.
“The group in which we are most worried about safety – the under-fives – had not been tested and could not get [dupilumab]”, says Paller. “The effect for most of these young children is dramatic and at least as good as we have seen with risky immunosuppressive drugs.”
Dupilumab already has a safety profile marked as “exceptional,” and no further lab testing is needed. It is now available for children as young as 6 months old, and a parent or healthcare professional can administer the drug as a monthly injection.
Additionally, researchers believe it may also have preventive effects. Because it takes such an aggressive approach to calm the immune system’s inflammatory response, chances are it will also protect against other allergic issues that develop later in life.
Dupilumab may even prove useful for treating other health conditions in young children, the researchers suggest – although more studies are needed to determine how effective it might be.
“Being able to take this drug will dramatically improve the quality of life for infants and young children who suffer greatly from this disease,” says Paller.
“Atopic dermatitis or eczema is much more than just itchy skin. It is a devastating disease. The quality of life of severe eczema – not only for the child but also for the parents – equals many diseases potentially deadly.”
The research was sponsored by Regeneron Pharmaceuticals and Sanofi, who jointly developed dupilumab, and the study was published in The Lancet.
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