{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T14:08:04Z","timestamp":1792591684096,"version":"4.5.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T00:00:00Z","timestamp":1681948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The real-world experience of dupilumab in Chinese is limited, and the initial loading dose has not yet been deeply explored in patients aged &amp;lt;6 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore the efficacy and safety of dupilumab in Chinese patients with moderate-to-severe atopic dermatitis and investigate the effect of higher loading dose for disease control in patients aged &amp;lt;6 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 155 patients were divided into three groups according to age: &amp;lt;6 years, 6-11 years, and &amp;gt;11 years. Among patients aged &amp;lt;6 years, 37 patients received a high loading dose of 300 mg for body weight &amp;lt;15kg or 600 mg for body weight \u226515kg, and another 37 patients received a standard loading dose of 200 mg for body weight &amp;lt;15kg or 300 mg for body weight \u226515kg. Multiple physicians and patient-reported outcome measures were evaluated at baseline and 2, 4, 6, 8, 12, and 16 weeks after dupilumab treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The proportion of patients showing an improvement of \u226575% in the Eczema Area and Severity Index was 68.0% (17\/25), 76.9% (10\/13), and 62.5% (25\/40) in the aged &amp;lt;6, 6-11, and &amp;gt;11 years groups, respectively, at week 16. After increasing the loading dose, 69.6% (16\/23) of patients aged &amp;lt;6 years achieved 4-point improvement in Pruritus Numerical Rating Scale at week 2, compared with 23.5% (8\/34) of patients receiving standard loading dose (<jats:italic>P<\/jats:italic> &amp;lt; 0.001). Obesity (odds ratio=0.12, 95% confidence interval: 0.02-0.70) was predictive of a poor response to dupilumab treatment, while female (odds ratio=3.94, 95% confidence interval: 1.26-12.31) predicted good response at week 16. The change of serum C-C motif ligand 17(CCL17\/TARC) could reflect the response to dupilumab (<jats:italic>r<\/jats:italic> = 0.53, <jats:italic>P<\/jats:italic> = 0.002 in EASI) among patients aged &amp;lt;18 years. No major adverse events were reported during the treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Dupilumab was effective and well-tolerated in Chinese patients with atopic dermatitis. The increased loading dose helped achieve rapid pruritus control in patients aged &amp;lt;6 years.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2023.1160710","type":"journal-article","created":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T14:42:37Z","timestamp":1682001757000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["High loading-dose of dupilumab resulted in rapid disease control in pediatric patients with atopic 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