Eczema (or atopic dermatitis) affects millions of people, especially children under the age of six.
The chronic inflammatory skin disease causes the skin to become red, dry, weeping and itchy, making life very uncomfortable.
There is currently no cure for the condition, only ways to treat it – but an existing drug is incredibly effective at reducing the signs and symptoms of eczema in children under the age of six with moderate to severe cases of the condition.
It’s the first time a complex biological drug like this has been tested in 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 received dupilumab or a placebo for 16 weeks.
More than half of the children given the drug showed a 75 percent reduction in the severity of symptoms. The itching was significantly reduced and the children could sleep much better.
“Preschoolers who are constantly scratching, waking up with their parents multiple times during the night, irritable, and significantly limited in their ability to do what other children their age can do, improved in terms of being able to sleep through the night.” sleep through the night, change their personality, and live a normal life—as babies and children should,” says dermatologist Amy Paller of Northwestern University in Illinois.
Dupilumab targets a key immune system inflammatory pathway in allergy and is already used to treat eczema in older children and adults, as well as asthma, nasal polyps and other allergy-related problems.
Until now, it hadn’t been approved as safe or confirmed to be effective for people under the age of six — about 19 percent of this population is thought to have eczema, while 85 to 90 percent of those who develop eczema in their lifetime see the first signs of it before they die fifth year of life.
About a third of this age group with eczema has a moderate to severe case of the condition accompanied by a debilitating itch: These children are unable to sleep properly, with all sorts of implications and consequences.
While immunosuppressive drugs like oral steroids are often used for severe cases of eczema, Paller says there are concerns about their suitability for young children — both in terms of short-term side effects and long-term health complications.
“The group we are most concerned about safety in – those under five – hadn’t been tested and couldn’t get it [dupilumab]’ Paller says. “The effect for most of these younger children is dramatic and at least as good as we’ve seen with the risky immunosuppressive drugs.”
Dupilumab already has an excellent safety profile, with no further laboratory testing required. It’s now available for children as young as 6 months, and either a parent or healthcare professional can administer the drug through a monthly injection.
In addition, researchers believe it may also have preventative effects. Because it takes such an aggressive approach to calming the immune system’s inflammatory response, there’s a good chance it might also protect against other allergic problems that develop later in life.
Dupilumab could even prove useful in treating other health problems in younger children, the researchers suggest — although more studies will be needed to determine how else it might be effective.
“Being able to take this drug will greatly improve the quality of life for infants and young children who suffer tremendously from this disease,” says Paller.
“Atopic dermatitis, or neurodermatitis, is so much more than just itchy skin. It’s a devastating disease. The quality of life of a severe neurodermatitis – not only for the child, but also for the parents – corresponds to many life-threatening diseases.
The research was sponsored by Regeneron Pharmaceuticals and Sanofi, who jointly developed dupilumab, and the study was published in The lancet.