度普利尤单抗治疗儿童中重度特应性皮炎短期疗效与复发风险: 一项单中心回顾性研究

doi:10.12372/jcp.2026.25e1604

摘要/Abstract

摘要：

目的评估度普利尤单抗治疗中重度特应性皮炎（AD）患儿的短期疗效及停药后的复发情况。方法回顾性分析2024年1月至2025年3月于皮肤科门诊就诊并完成16周度普利尤单抗治疗的中重度AD患儿的临床资料。根据年龄与体重给予度普利尤单抗标准方案治疗。比较患儿基线及治疗第4、8、12、16周时的特应性皮炎评分（SCORAD）、湿疹面积和严重程度指数（EASI）、儿童瘙痒量化评分（ItchyQuant）及患者湿疹自我检查评分（POEM）。对治疗满16周后停药12周的患儿进行随访，评估复发情况。结果共纳入41例中重度AD患儿，男22例、女19例，中位年龄8.00（5.50~10.00）岁。基线以及度普利尤单抗治疗第4、8、12、16周之间患儿SCORAD、EASI、ItchyQuant及POEM评分的差异均有统计学意义（均P<0.001）。两两比较发现，与基线相比，SCORAD、EASI评分在第8、12、16周均显著下降（均P<0.001）；ItchyQuant及POEM评分在第4、8、12、16周均显著下降（均P<0.001）。在治疗16周时达到EASI-50、EASI-75、EASI-90、EASI-100的患儿分别为35例（85.37%）、22例（53.66%）、10例（24.39%）、1例（2.44%）。共随访33例停药12周患儿，末次治疗（第16周）与停药后4、8、12周的SCORAD、EASI、ItchyQuant、POEM评分比较，差异均有统计学意义（均P<0.001）。两两比较发现，停药后12周时，SCORAD、EASI、ItchyQuant及POEM评分均较末次治疗时显著回升（P<0.001）。尽管评分显著回升，但停药12周时的SCORAD、EASI、ItchyQuant及POEM评分仍显著低于基线水平（均P<0.001）。依据不同临床恶化标准，EASI评分较停药时增加≥50%且EASI≥7分的患儿8例（24.24%），ItchyQuant评分较停药时增加≥3分且ItchyQuant≥4分的患儿10例（30.30%），POEM较停药时增加≥4分且POEM≥8分的患儿12例（36.36%）。结论度普利尤单抗治疗16周可显著改善中重度AD患儿的皮损及瘙痒症状，但停药12周后存在一定的复发风险。

关键词: 度普利尤单抗, 特应性皮炎, 复发, 儿童

Abstract:

Objective To evaluate the short-term efficacy of dupilumab in the treatment of moderate to severe atopic dermatitis (AD) in children and the recurrence after drug withdrawal. Methods A retrospective study was conducted, including children with moderate to severe AD who visited the dermatology outpatient department from January 2024 to March 2025 and completed 16 weeks of dupilumab treatment. Dupilumab was administered according to the standard protocol based on age and weight. The Atopic Dermatitis Score (SCORAD), Eczema Area and Severity Index (EASI), ItchyQuant, and Patient-Oriented Eczema Measure (POEM) scores of the children were compared at baseline and at weeks 4, 8, 12, and 16 of treatment. Follow-up was conducted for 12 weeks after drug withdrawal in children who completed 16 weeks of treatment to assess recurrence. Results A total of 41 children with moderate-to-severe atopic dermatitis (AD) were enrolled, including 22 boys and 19 girls, with a median age of 8.00 (5.50-10.00) years. Statistically significant differences were observed in SCORAD, EASI, ItchyQuant, and POEM scores between baseline and weeks 4, 8, 12, and 16 of dupilumab treatment (all P<0.001). Pairwise comparisons revealed that, compared with baseline, SCORAD and EASI scores decreased significantly at weeks 8, 12, and 16 (all P<0.001); ItchyQuant and POEM scores decreased significantly at weeks 4, 8, 12, and 16 (all P<0.001). At week 16 of treatment, 35 (85.37%), 22 (53.66%), 10 (24.39%), and 1 (2.44%) children achieved EASI-50, EASI-75, EASI-90, and EASI-100, respectively. A total of 33 children were followed up for 12 weeks after treatment discontinuation. Overall comparisons of SCORAD, EASI, ItchyQuant, and POEM scores between the last treatment (week 16) and weeks 4, 8, and 12 after discontinuation showed statistically significant differences (all P<0.001). Pairwise comparisons indicated that at 12 weeks after discontinuation, SCORAD, EASI, ItchyQuant, and POEM scores were significantly increased compared with the last treatment (P<0.001). Despite significant rebound, SCORAD, EASI, ItchyQuant, and POEM scores at 12 weeks after discontinuation remained significantly lower than baseline levels (all P<0.001). According to different criteria for clinical deterioration, 8 children (24.24%) had an EASI increase ≥50% from the time of discontinuation with EASI≥7 points; 10 children (30.30%) had an ItchyQuant increase≥3 points from the time of discontinuation with ItchyQuant≥4 points; and 12 children (36.36%) had a POEM increase≥4 points from the time of discontinuation with POEM≥8 points. Conclusions Sixteen weeks of dupilumab treatment significantly improved skin lesions and pruritus symptoms in children with moderate-to-severe AD; however, a certain risk of relapse exists 12 weeks after treatment discontinuation.

Key words: dupilumab, atopic dermatitis, recurrence, child

中图分类号:

郝延召, 李弯月, 李建国, 窦进法, 禹卉千, 王建波. 度普利尤单抗治疗儿童中重度特应性皮炎短期疗效与复发风险: 一项单中心回顾性研究[J]. 临床儿科杂志, 2026, 44(5): 412-417.

HAO Yanzhao, LI Wanyue, LI Jianguo, DOU Jinfa, YU Huiqian, WANG Jianbo. Short-term efficacy and recurrence risk of dupilumab in the treatment of moderate to severe atopic dermatitis in children: a single-center retrospective study[J]. Journal of Clinical Pediatrics, 2026, 44(5): 412-417.

图/表 2

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项目	基线（0周）	第4周	第8周	第12周	第16周	χ²值	P
SCORAD	56.20 (43.55~66.35)	29.40 (23.65~40.75)	22.10 (14.90~27.90)¹⁾	16.30 (10.90~19.75)¹⁾	11.30 (7.30~13.45)¹⁾	161.62	<0.001
EASI	25.60 (18.05~35.60)	17.50 (10.90~26.75)	12.20 (6.40~17.05)¹⁾	8.20 (4.40~12.90)¹⁾	5.40 (2.25~9.30)¹⁾	160.84	<0.001
ItchyQuant	6.00 (5.50~7.00)	3.00 (2.50~4.00)¹⁾	3.00 (2.00~3.00)¹⁾	1.00 (1.00~2.00)¹⁾	1.00 (0.00~1.00)¹⁾	151.05	<0.001
POEM	18.00 (14.00~23.00)	12.00 (7.00~14.00)¹⁾	7.00 (5.00~9.50)¹⁾	4.00 (3.00~6.00)¹⁾	2.00 (1.00~4.00)¹⁾	160.48	< 0.001

项目	末次治疗（第16周）	停药后4周	停药后8周	停药后12周	χ²值	P
SCORAD	12.40(7.85~14.05)	11.20(7.10~12.95)	13.60(9.40~16.40)	17.70(10.20~21.75)¹⁾	66.72	<0.001
EASI	6.90(2.40~10.15)	6.10(2.75~10.00)	7.10(2.80~10.05)	7.80(3.50~12.60)¹⁾	30.75	<0.001
ItchyQuant	1.00(0.00~1.00)	1.00(0.50~1.50)	2.00(1.00~2.50)¹⁾	3.00(2.00~4.00)¹⁾	68.71	<0.001
POEM	3.00(1.50~5.50)	2.00(1.00~4.00)¹⁾	2.00(1.00~8.00)¹⁾	3.00(1.00~10.50)¹⁾	45.51	<0.001