Dupilumab Associated With Improved Height Growth and Bone Mineralization Markers in Children With Severe Atopic Dermatitis

Dupilumab treatment was associated with improvements in height growth and bone mineralization markers among children with severe atopic dermatitis (AD), according to findings from a phase 3 trial and subsequent open-label extension.

The study evaluated children aged 6 to 11 years with severe AD who received dupilumab or placebo for 16 weeks, followed by dupilumab treatment in an open-label extension through week 52. Investigators assessed height percentile distribution at baseline, changes in height percentiles, and bone alkaline phosphatase (BALP), a biomarker of bone mineralization.

At baseline, children with severe AD were disproportionately represented in lower height percentiles, suggesting potential growth-related effects associated with the disease.

Among children below the 40th height percentile at baseline, 31.3% of those receiving dupilumab achieved a height increase of at least 5 percentile points at week 16, compared with 15.5% receiving placebo (P<.05).

By week 52, 50.7% of dupilumab-treated children who were initially below the 40th height percentile achieved an increase of at least 5 percentile points.

BALP levels remained within the normal range throughout the study but were significantly higher among dupilumab-treated patients compared with placebo recipients at week 16. Additional increases were observed through week 52.

Children who initially received placebo and transitioned to dupilumab at week 16 demonstrated improvements in height and BALP comparable to those who received dupilumab throughout the study.

The investigators noted that “moderate and severe atopic dermatitis (AD) may affect bone growth and mineral density in children,” highlighting the importance of evaluating growth-related outcomes in pediatric patients.

The study assessed the “proportion of patients achieving ≥5-percentile height increase” alongside changes in BALP levels to characterize treatment-associated outcomes.

Reference
Irvine AD, Paller AS, Siegfried EC, et al. 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;95(5):1324-1334. doi:10.1016/j.jaad.2026.07.006