New research from Trinity College Dublin has documented the significant impact of severe eczema on a child’s height, and has also shown, for the first time in a controlled study, that the right treatment can help improve growth.
The study investigating the effect of a drug commonly used to treat eczema, also known as atopic dermatitis (AD), has been published in the peer-reviewed Journal of the American Academy of Dermatology. The study of 123 children focused on growth and bone biomarkers in six-to-11 year-olds with severe eczema.
It found that children who have severe AD and growth restriction and received a targeted biologic drug, dupilumab, grew more than those with similar AD and growth restriction who did not receive the treatment. The findings imply that early and effective treatment of children with severe eczema could have life-long implications for a child’s growth.
The research was undertaken by Prof Alan Irvine, Professor of Dermatology in Trinity’s School of Medicine, in collaboration with researchers from Regeneron and Sanofi, companies that had conducted clinical trials of dupilumab for eczema. This drug is now approved and widely used in clinic settings worldwide for the treatment of eczema. Analysing data from the original clinical trial the team found that children who had severe eczema were, on average, shorter than population norms.
When their growth was tracked through the clinical trials, it was clear that those who were most growth-restricted benefited greatly from dupilumab treatment, with significant increases in height over the first 16 weeks of the trial.
After 16 weeks, the group who had been given placebo were switched to dupilumab and they too rapidly caught up growth. Blood markers that measure new bone growth also reflected normal growth. “Eczema is the commonest skin disorder in children worldwide. It is typically an itchy and painful rash that interferes with sleep and has a very significant impact on quality of life in affected children,” explains Prof Irvine.
“Children who live with severe eczema often have delayed growth that is poorly understood but is thought to be due to a combination of factors, including the energy needed to maintain inflammation, sleep disruption and possibly the effects of steroid treatments for the condition.
“These findings are good news for children living with eczema. Effective treatment of eczema not only improves the skin, but it may also help children grow at a more normal rate and support healthy bone development.
“We don’t yet know what is behind this improved growth rate. It may be that reducing chronic inflammation helps the body grow, or it may be because better sleep, thanks to improved itch, supports growth. Further research is needed to understand the mechanisms at play.”
