Real-world effectiveness and safety of dupilumab in children with atopic dermatitis: a Latin American single-center study

BACKGROUND: Atopic dermatitis (AD) is common in children (affecting ~20% of children globally) and imposes a substantial burden. Many children in Latin America have moderate-to-severe AD with limited access to advanced therapies, highlighting an unmet need for safe and effective treatment options. Dupilumab, a targeted anti-interleukin-4 (IL-4)-IL-13 biologic, has demonstrated efficacy in pediatric AD, but real-world data in Latin American children are scarce. METHODS: We conducted a single-center retrospective observational study in Mexico City with children (aged 4-18 years) with moderate-to-severe AD treated with dupilumab from 2018 to 2024. Clinical outcomes (Eczema Area and Severity Index; Scoring Atopic Dermatitis [SCORAD], and pruritus Numerical Rating Scale [NRS]) and quality-of-life (Dermatology Life Quality Index) were assessed at baseline and ~3, ~6, and ~12 months. Changes over time were analyzed using nonparametric tests, and adverse events were documented. RESULTS: In all, 23 children (~50% female) with severe, treatment-refractory AD were included. Dupilumab led to rapid and significant improvement in all endpoints (P < 0.001). In 12 months, most patients achieved clear or almost clear skin with no pruritus (median SCORAD and itch NRS = 0), and quality-of-life scores improved from a median of 19 to 3. No serious adverse events occurred; mild conjunctivitis was reported in 13% patients (with one discontinuation). CONCLUSION: In this Latin American pediatric cohort, dupilumab achieved marked and sustained improvements in disease severity and quality of life, with a favorable safety profile. This real-world study addresses a regional evidence gap and supports dupilumab as an effective and well-tolerated treatment for moderate-to-severe pediatric AD.