Real-World Systemic Treatment Outcomes for Moderate-to-Severe Atopic Dermatitis in Children by Skin Color: 4-Year Results from the observational, international, real-world PEDISTAD Registry.

BACKGROUND: Atopic dermatitis (AD) can have different genetic, immunopathogenic, and clinical features depending on the ethnicity of the affected individual. OBJECTIVE: To investigate if White and non-White children with moderate-to-severe AD respond differently to systemic treatment. METHODS: PEDISTAD is an observational, international, real-world study. Patients were analyzed in two subgroups: non-White and White. Non-White included Black/African American, Asian, American Indian or Alaskan-Native and Multiracial. RESULTS: 314 White, and 186 non-White children <12 years were included. Eczema-area-and-severity -index improved significantly for all: 13.6, 8.2 and 9.2 point-improvement with dupilumab, methotrexate and cyclosporine, respectively (non-White); and 14.2, 10.1 and 4.5 point-improvement (White). Itch scores improved significantly with dupilumab for both subgroups. Cyclosporine was the least effective at reducing itch in this study. Quality-of-life metrics were observed to improve similarly in both groups with dupilumab, to a greater extent than with methotrexate or cyclosporine. The Exposure-adjusted adverse event rate was highest in White children: 33.33, 33.24 and 58.33 events/per 100 person years for dupilumab, methotrexate and cyclosporine respectively, versus 28.28, 20.86 and 28.72 events/per 100 person years in the non-White children. CONCLUSION: In this study, patients that received dupilumab had a greater observed improvement in clinician-, and patient-reported outcomes compared with patients receiving methotrexate and cyclosporine irrespective of skin color/race.