American journal of translational research · 2026
Development of a clinical indicator-based severity scoring system for pediatric atopic dermatitis and evaluation of dupilumab treatment outcomes.
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Ding Peng, Zhang Dongbo, Deng Xi, Shi Hui
Аннотация
OBJECTIVE: To develop and validate a pediatric atopic dermatitis (AD) severity scoring system based on routinely available clinical indicators and to evaluate the efficacy and safety of dupilumab in children with moderate-to-severe AD.
METHODS: Clinical data from 236 children with AD treated between January 2023 and January 2025 were retrospectively analyzed and randomly split into training and internal validation cohorts (7:3). An external validation cohort included 42 patients treated between February and June 2025. AD severity was classified using the SCORAD index. Factors associated with disease severity were identified by logistic regression, and a scoring system was developed and evaluated using receiver operating characteristic (ROC) and calibration curves. In addition, children with moderate-to-severe AD treated with dupilumab were assessed for changes in clinical scores at baseline and weeks 4, 12, and 16, with adverse events recorded.
RESULTS: The scoring system (0-9 points) included onset age ≤2 years, xerosis, spiny lichen, vitamin D insufficiency/deficiency, and eosinophil count ≥0.455×109/L. The areas under the ROC curve were 0.885 in the internal validation cohort and 0.824 in the external validation cohort, with good calibration. Dupilumab treatment significantly improved EASI, SCORAD, PP-NRS scores. At week 16, EASI50, EASI75, and EASI90 were achieved in 86.52%, 65.17%, and 33.71% of patients, respectively. Adverse events were mild and infrequent.
CONCLUSIONS: A simple and practical severity scoring system for pediatric AD was developed and validated. Dupilumab demonstrated favorable efficacy and acceptable safety in children with moderate-to-severe AD.
METHODS: Clinical data from 236 children with AD treated between January 2023 and January 2025 were retrospectively analyzed and randomly split into training and internal validation cohorts (7:3). An external validation cohort included 42 patients treated between February and June 2025. AD severity was classified using the SCORAD index. Factors associated with disease severity were identified by logistic regression, and a scoring system was developed and evaluated using receiver operating characteristic (ROC) and calibration curves. In addition, children with moderate-to-severe AD treated with dupilumab were assessed for changes in clinical scores at baseline and weeks 4, 12, and 16, with adverse events recorded.
RESULTS: The scoring system (0-9 points) included onset age ≤2 years, xerosis, spiny lichen, vitamin D insufficiency/deficiency, and eosinophil count ≥0.455×109/L. The areas under the ROC curve were 0.885 in the internal validation cohort and 0.824 in the external validation cohort, with good calibration. Dupilumab treatment significantly improved EASI, SCORAD, PP-NRS scores. At week 16, EASI50, EASI75, and EASI90 were achieved in 86.52%, 65.17%, and 33.71% of patients, respectively. Adverse events were mild and infrequent.
CONCLUSIONS: A simple and practical severity scoring system for pediatric AD was developed and validated. Dupilumab demonstrated favorable efficacy and acceptable safety in children with moderate-to-severe AD.