New research from Trinity College Dublin has documented the significant impact of severe eczema/atopic dermatitis (AD) 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 targeted biologic drug on stature, height gain, and biomarker of mineralisation, bone alkaline phosphatase (BALP) level over time in children with AD – was recently published in the peer-reviewed Journal of the American Academy of Dermatology.
The study focused on growth and bone biomarkers in 123 children aged six to 11 years with severe eczema who received dupilumab or placebo in a phase 3 trial for 16 weeks, followed by dupilumab in an open-label trial to week 52.
Endpoints included baseline height percentile distribution, proportion of patients achieving ≥5-percentile height increase at weeks 16 and 52, and BALP level to week 52.
The study results found that children who have severe AD and growth restriction and received dupilumab, grew more than those with similar AD and growth restriction who did not receive the treatment: Among dupilumab-treated children below the 40th height percentile at baseline, 31.3 per cent achieved ≥5-percentile height increase (versus 15.5 per cent with placebo, P <.05) at week 16, and 50.7 per cent at week 52. BALP level, while within normal range throughout, was significantly higher with dupilumab versus placebo at week 16, with a further increase to week 52. At week 52, patients who transitioned to dupilumab at week 16 attained height and BALP improvements comparable with patients receiving dupilumab throughout.
The findings imply that early and effective treatment of children with severe eczema could have lifelong implications for a child’s growth.
The research was undertaken by Alan Irvine, Professor of Dermatology in Trinity’s School of Medicine, in collaboration with researchers from pharmaceutical 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.
“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,” noted 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,” he said.
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.
These findings are good news for children living with eczema, Prof Irvine stated. “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.”
He acknowledged that researchers do not yet know what is behind this improved growth rate so further research is needed. “It may be that reducing chronic inflammation helps the body grow or it may be because of better sleep, thanks to improved itch, supports growth. Further research is needed to understand the mechanisms at play.”
Useful information resources and supports for parents of children with eczema are available on the Irish Skin Foundation website at: https://irishskin.ie/eczema/
Reference
- Irvine AD, Paller AS, Siegfried EC, Cork MJ, Beck LA, Eichenfield LF, et al. Dupilumab treatment improves linear growth and bone biomarkers in children with atopic dermatitis: Post hoc analysis of a phase 3 randomised, placebo-controlled clinical trial, and an open-label extension study. J Am Acad Dermatol. 2026 Jul 7:S0190-9622(26)03071-9.
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