Post Hoc Analysis Shows Dupilumab Improves Linear Growth in Pediatric Atopic Dermatitis
Key Clinical Summary
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Dupilumab was associated with improved linear growth in children aged 6 to 11 years with severe atopic dermatitis, a population that was overrepresented in lower height percentiles at baseline.
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Among children below the 40th height percentile, 31.3% of those receiving dupilumab achieved a ≥5-percentile increase in height by week 16 versus 15.5% with placebo (P <.05); by week 52, 50.7% of dupilumab-treated children achieved this growth threshold.
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Bone alkaline phosphatase levels also improved with dupilumab, remaining within the normal range but increasing significantly vs placebo at week 16 and further through week 52. The analysis was limited by its 1-year duration.
Dupilumab treatment was associated with improvements in linear growth and a bone mineralization biomarker among children with severe atopic dermatitis (AD), according to a post hoc analysis of a phase 3 randomized trial and open-label extension study.
Study Findings
Investigators evaluated stature, height gain, and bone alkaline phosphatase (BALP) levels over time in children aged 6 to 11 years with severe AD. The investigators noted that “moderate and severe AD may affect bone growth and mineral density in children.”
Participants initially received dupilumab or placebo for 16 weeks in a phase 3 trial, followed by dupilumab during an open-label extension through week 52. Outcomes included baseline height percentile distribution, the proportion of children achieving a height increase of at least 5 percentiles, and BALP levels.
At baseline, children with severe AD were disproportionately represented in lower height percentiles. Among dupilumab-treated children who began below the 40th height percentile, 31.3% achieved an increase of at least 5 height percentiles by week 16, compared with 15.5% of placebo recipients (P <.05).
By week 52, 50.7% of children in this subgroup achieved an increase of at least 5 height percentiles.
Clinical Implications
BALP remained within the normal range throughout the study but was significantly higher among dupilumab-treated patients compared with placebo recipients at week 16 and increased further through week 52. Children who switched from placebo to dupilumab at week 16 ultimately experienced height and BALP improvements comparable with those treated with dupilumab throughout the study.
Expert Commentary
“Dupilumab treatment in children with AD was associated with height and BALP level improvements,” the authors concluded, identifying the study’s 1-year duration as a limitation.
The findings indicate that dupilumab treatment was associated with measurable changes in both linear growth and a marker of bone mineralization during 1 year of treatment in children with severe AD.
Reference
Dupilumab treatment improves linear growth and bone biomarkers in children with atopic dermatitis: post hoc analysis of a phase 3 randomized, placebo-controlled clinical trial and an open-label extension study. J Am Acad Dermatol. 2026:S0190-9622(26)03071-9. doi:10.1016/j.jaad.2026.07.006
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Any views and opinions expressed are those of the author(s) and/or participants and do not necessarily reflect the views, policy, or position of the Dermatology Learning Network or HMP Global, their employees, and affiliates.
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