Abstract：
BACKGROUND: Dupilumab effectively treats atopic dermatitis (AD); however, its role in halting the atopic march remains uncertain.
OBJECTIVE: To investigate dupilumab\'s effect on atopic march in pediatric AD patients versus conventional immunomodulators.
METHODS: This retrospective cohort study utilized data from the TriNetX US Collaborative Network (2011-2024). Pediatric AD patients (≤18 years) were categorized into DUPI-cohort (newly prescribed dupilumab) or CONV-cohort (prescribed conventional immunomodulators without dupilumab). After 1:1 propensity-score matching, we analyzed atopic march progression, defined by the incident asthma or allergic rhinitis (AR). Cumulative incidence was plotted using Kaplan-Meier, with risk assessment via Cox regression.
RESULTS: The study included 2192 patients in each cohort. The 3-year cumulative incidence of atopic march progression was lower in the DUPI-cohort than the CONV-cohort (20.09% vs 27.22%; P < .001). The DUPI-cohort demonstrated significant risk reduction in atopic march progression (hazard ratio [HR] 0.68, 95% CI 0.55-0.83), individual asthma (HR 0.60, 0.45-0.81), and individual AR (HR 0.69, 0.54-0.88). Younger patients on dupilumab exhibited a greater risk reduction for atopic march progression and individual asthma, contrasting with the opposite age-related pattern for individual AR.
CONCLUSIONS: Observational study.
CONCLUSIONS: Among pediatric AD patients, dupilumab was associated with reduced risk of atopic march progression compared with conventional therapies.
OBJECTIVE: To investigate dupilumab\'s effect on atopic march in pediatric AD patients versus conventional immunomodulators.
METHODS: This retrospective cohort study utilized data from the TriNetX US Collaborative Network (2011-2024). Pediatric AD patients (≤18 years) were categorized into DUPI-cohort (newly prescribed dupilumab) or CONV-cohort (prescribed conventional immunomodulators without dupilumab). After 1:1 propensity-score matching, we analyzed atopic march progression, defined by the incident asthma or allergic rhinitis (AR). Cumulative incidence was plotted using Kaplan-Meier, with risk assessment via Cox regression.
RESULTS: The study included 2192 patients in each cohort. The 3-year cumulative incidence of atopic march progression was lower in the DUPI-cohort than the CONV-cohort (20.09% vs 27.22%; P < .001). The DUPI-cohort demonstrated significant risk reduction in atopic march progression (hazard ratio [HR] 0.68, 95% CI 0.55-0.83), individual asthma (HR 0.60, 0.45-0.81), and individual AR (HR 0.69, 0.54-0.88). Younger patients on dupilumab exhibited a greater risk reduction for atopic march progression and individual asthma, contrasting with the opposite age-related pattern for individual AR.
CONCLUSIONS: Observational study.
CONCLUSIONS: Among pediatric AD patients, dupilumab was associated with reduced risk of atopic march progression compared with conventional therapies.
摘要：
背景：Dupilumab可有效治疗特应性皮炎（AD）；然而，它在阻止特应性游行中的作用仍然不确定。
目的：研究dupilumab对小儿AD患者特应性行军的影响，与常规免疫调节剂相比。
方法：这项回顾性队列研究利用了TriNetX美国合作网络(2011-2024)的数据。小儿AD患者（≤18岁）分为DUPI队列（新处方dupilumab）或CONV队列（处方常规免疫调节剂，不含dupilumab）。1:1倾向得分匹配后，我们分析了特应性行军进展，定义为哮喘或过敏性鼻炎（AR）。累积发病率用Kaplan-Meier作图，通过Cox回归进行风险评估。
结果：该研究包括每个队列中的2192名患者。在DUPI队列中，特应性行军进展的3年累积发生率低于CONV队列（20.09％vs27.22％；P<.001）。DUPI队列显示特应性行军进展的风险显着降低（风险比[HR]0.68，95％CI0.55-0.83），个体哮喘（HR0.60，0.45-0.81），和个体AR（HR0.69，0.54-0.88）。使用dupilumab的年轻患者表现出更大的特应性进展和个体哮喘的风险降低，与个体AR的年龄相关模式相反。
结论：观察性研究。
结论：在小儿AD患者中，与常规治疗相比,dupilumab与特应性进展风险降低相关.
目的：研究dupilumab对小儿AD患者特应性行军的影响，与常规免疫调节剂相比。
方法：这项回顾性队列研究利用了TriNetX美国合作网络(2011-2024)的数据。小儿AD患者（≤18岁）分为DUPI队列（新处方dupilumab）或CONV队列（处方常规免疫调节剂，不含dupilumab）。1:1倾向得分匹配后，我们分析了特应性行军进展，定义为哮喘或过敏性鼻炎（AR）。累积发病率用Kaplan-Meier作图，通过Cox回归进行风险评估。
结果：该研究包括每个队列中的2192名患者。在DUPI队列中，特应性行军进展的3年累积发生率低于CONV队列（20.09％vs27.22％；P<.001）。DUPI队列显示特应性行军进展的风险显着降低（风险比[HR]0.68，95％CI0.55-0.83），个体哮喘（HR0.60，0.45-0.81），和个体AR（HR0.69，0.54-0.88）。使用dupilumab的年轻患者表现出更大的特应性进展和个体哮喘的风险降低，与个体AR的年龄相关模式相反。
结论：观察性研究。
结论：在小儿AD患者中，与常规治疗相比,dupilumab与特应性进展风险降低相关.
