Evidence map›Paper›PMID 38267692›Full record

Trial reportPaediatric drugs2024

Infections in Children Aged 6 Months to 5 Years Treated with Dupilumab in a Placebo-Controlled Clinical Trial of Moderate-to-Severe Atopic Dermatitis.

Amy S Paller, Elaine C Siegfried, Michael J Cork, Peter D Arkwright, Lawrence F Eichenfield, Michele Ramien, Faisal A Khokhar, Zhen Chen, Annie Zhang, Sonya L Cyr

Registry-linked trialOpen access · hybridAbstract readRandomized Controlled TrialClinical Trial, Phase III
In one paragraph

Trial report in Paediatric drugs, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03346434 (A Phase 2/3 Study Investigating the Pharmacokinetics, Safety, and Efficacy of Dupilumab in Patients Aged ≥6 Months to <6 Years With Moderate-to-Severe Atopic Dermatitis), which is not on this map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
4.3field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03346434 phase2 / phase3completednot on this map

A Phase 2/3 Study Investigating the Pharmacokinetics, Safety, and Efficacy of Dupilumab in Patients Aged ≥6 Months to <6 Years With Moderate-to-Severe Atopic Dermatitis

TypeinterventionalSponsorRegeneron PharmaceuticalsRan2017 to 2021Enrolled202ConditionsDermatitis, AtopicArmsDupilumab, Matching placebo
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 8 institutions in 3 countries.

Amy S PallerDepartment of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Elaine C SiegfriedSaint Louis University School of Medicine, St. Louis, MO, USA.
Michael J CorkSheffield Dermatology Research, University of Sheffield, Sheffield, UK.
Peter D ArkwrightLydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK.
Lawrence F EichenfieldDepartments of Dermatology and Pediatrics, University of California San Diego, La Jolla, CA, USA.
Michele RamienDivision of Dermatology, Department of Medicine, University of Calgary, Calgary, AB, Canada.
Faisal A KhokharRegeneron Pharmaceuticals Inc., Tarrytown, NY, USA.
Zhen ChenRegeneron Pharmaceuticals Inc., Tarrytown, NY, USA.
Annie ZhangSanofi, Cambridge, MA, USA.
Sonya L CyrRegeneron Pharmaceuticals Inc., Tarrytown, NY, USA. sonya.cyr@regeneron.com.
Regeneron (United States) · USLurie Children's Hospital · USSaint Louis University · USSanofi (United States) · USSheffield Children's Hospital · GBUniversity of Calgary · CAUniversity of California, San Diego · USUniversity of Manchester · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with atopic dermatitis (AD), particularly infants and young children, are at greater risk of developing skin infections. In this study, we assessed infection rates in AD patients aged 6 months to 5 years treated with dupilumab.

methodsIn LIBERTY AD PRESCHOOL, a double-blind, placebo-controlled, phase III clinical trial, children aged 6 months to 5 years with moderate-to-severe AD were randomized 1:1 to subcutaneous dupilumab or placebo, with concomitant low-potency topical corticosteroids, every 4 weeks for 16 weeks. Exposure-adjusted infection rates were used to compare treatment groups.

resultsThe analysis included 162 patients, of whom 83 received dupilumab and 79 received placebo. Total infection rates were not significantly different between the dupilumab and placebo groups (rate ratio [RR] 0.75, 95% CI 0.48-1.19; p = 0.223). Non-herpetic adjudicated skin infections and bacterial infections were significantly less frequent with dupilumab versus placebo (non-herpetic skin infections: RR 0.46, 95% CI 0.21-0.99; p = 0.047; bacterial infections: RR 0.09, 95% CI 0.01-0.67; p = 0.019), and the number of patients using systemic anti-infective medication was significantly lower in the dupilumab group (RR 0.52, 95% CI 0.30-0.89; p = 0.019). There were no significant differences in the number of herpetic infections between the dupilumab and placebo groups (RR 1.17, 95% CI 0.31-4.35; p = 0.817). The number of patients with two or more infection events was significantly higher in the placebo group (RR 0.29, 95% CI 0.12-0.68; p = 0.004), and no severe or serious infections (including eczema herpeticum) were observed among patients receiving dupilumab.

conclusionsThese data suggest that dupilumab treatment in infants and children younger than 6 years with AD does not increase overall risk of infections and is associated with a reduced risk of bacterial and non-herpetic skin infections compared with placebo, resulting in a reduced need for anti-infective medication.

trial registrationThe trial was registered with ClinicalTrials.gov with ID number NCT03346434 on November 17, 2017. INFOGRAPHIC.

Indexed as

Antibodies, Monoclonal, HumanizedBacterial InfectionsDermatitis, AtopicAntibodies, MonoclonalChildChild, PreschoolDouble-Blind MethodHumansInjections, SubcutaneousSeverity of Illness IndexTreatment OutcomeAntibodies, MonoclonalAntibodies, Monoclonal, Humanizeddupilumab

Identifiers

PMID38267692
PMCPMC10890978
OpenAlexW4391167053

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.