Dupilumab helps growth in children with severe eczema

Sixteen weeks was the turning point in a clinical trial involving children whose severe eczema and restricted growth had already put height in focus. Researchers at Trinity College Dublin found that the most growth-restricted children grew more when treated with dupilumab than similar children who received a placebo.

The team analyzed data from 123 children aged 6 to 11 with severe atopic dermatitis, the medical term for eczema. On average, children with severe disease were shorter than population norms. During the trial, those given dupilumab showed significant increases in height over the first 16 weeks, while blood markers measuring new bone growth also reflected normal growth.

The comparison did not end there. After 16 weeks, the placebo group switched to dupilumab, and those children rapidly caught up in growth as well. The result comes from a post hoc analysis of a phase 3 randomized, placebo-controlled trial and an open-label extension study published in the Journal of the American Academy of Dermatology.

The researchers do not yet know what drives the faster growth. Severe eczema can disturb sleep through persistent itching, while the body may use energy to maintain chronic inflammation; the source also identifies possible effects from steroid treatments. Alan Irvine, professor of dermatology at Trinity's School of Medicine, said improved growth could reflect reduced inflammation, better sleep, or both.

So what changes in practice? Dupilumab is already approved and widely used for eczema, meaning the finding points to a possible added benefit of an available treatment for children with severe disease: supporting growth as well as improving the skin. It does not prove that every child will grow faster or establish lifelong effects, and the mechanism still needs further research.