TOPLINE

Children aged 5-11 years with moderate-to-severe atopic dermatitis (AD) had lower heights but higher weights and BMIs than reference percentiles, with the largest height deficit observed in boys, according to a study.

METHODOLOGY

• Researchers conducted a cross-sectional analysis of data from PEDISTAD, a global real-world observational registry of pediatric patients younger than 12 years with moderate-to-severe AD.
• A total of 1329 children from 106 sites across North America, Latin America, Europe, the Middle East, and Africa were included.
• Participants were grouped by age: < 5 years and 5 to < 12 years; gender- and age-specific z-scores and percentiles for height, weight, and BMI were calculated using CDC growth references.
• Mean Eczema Area and Severity Index (EASI) scores ranged from 13.4 to 14.9, with body surface area affected by AD ranging from 30.7% to 33.8%; sleep disturbances were reported by 40.1% of children aged 0 to < 5 years and 32.4% of those aged 5 to < 12 years.
• Current treatments included topical corticosteroids in 75.0%-78.7% of patients, systemic oral corticosteroids in 9.4%-4.2%, and dupilumab in 16%.

TAKEAWAY

• In children aged 5 to < 12 years, 72% of boys and 53% of girls were below the CDC 50th percentile for height. The average height percentile was 45th in boys and 49th in girls. The growth curve for boys aged 5 to < 12 years remained consistently below the 50th percentile. 
• Weight was above the 50th percentile in 56% of boys and 52% of girls aged 5 to < 12 years; consequently, BMI was above the 50th percentile in 70% of boys and 71% of girls in this age group. 
• In children aged 0 to < 5 years, height was below the 50th percentile for 48% of boys and 41% of girls, whereas BMI was above the 50th percentile in 66% of boys and 73% of girls. From ages 2 to 12 years, the smoothed BMI curves started at the 50th percentile at age 2 and approached the 75th percentile by ages 10-11 years, suggesting that the higher BMI pattern became more apparent with age. 
• No associations were reported between height, weight, or BMI and disease severity measures, including EASI, quality-of-life indices, sleep disturbance, itch severity, or the use of topical or oral corticosteroids. 

IN PRACTICE

“This study analysis found that moderate-to-severe AD might be associated with a reduced pediatric growth and increased BMI in children 5 to < 12 years of age, with height most affected in male children,” the authors of the study wrote. “Further studies are needed to confirm the findings,” they added, “and to ascertain whether effective disease control normalizes pediatric patient growth.”

SOURCE

The study was led by Amy S. Paller, MD, Department of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, and was published online on August 18 in Pediatric Dermatology.

LIMITATIONS

The use of US CDC growth curves may not be generalizable to all children in this international study. The baseline cross-sectional data may not reflect longitudinal changes in individual patient growth over time. Parental height, dietary restrictions, and other potential genetic factors associated with growth were not captured. The sample size could be small to detect correlations between sleep disturbance, nightly itch, and growth parameters.

DISCLOSURES

This research was supported by Sanofi and Regeneron Pharmaceuticals. Paller and other authors disclosed serving as investigators and consultants, being on data safety monitoring boards, holding stocks, and/or being employed at drug companies, including AbbVie, Abeona, BioCryst, Daiichi Sankyo, and Galderma. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.