Effectiveness and Safety of Omalizumab and Dupilumab in Treating Chronic Spontaneous Urticaria and Atopic Dermatitis in Pediatric Patients

Chronic spontaneous urticaria (CSU) and moderate-to-severe atopic dermatitis (AD) pose significant challenges for children, adversely affecting their quality of life (QoL). Biologic therapies like omalizumab and dupilumab have shown promise for patients refractory to conventional treatments. This study assessed the real-life effectiveness and safety of these biologics in pediatric patients with CSU and AD.

This retrospective, single-center study included pediatric patients aged 6 to 18 years. Participants enrolled had CSU unresponsive to antihistamines and moderate-to-severe AD not improving with topical treatments. The severity of the diseases and treatment effectiveness were measured using the Urticaria Activity Score 7 (UAS7) for CSU and the Eczema Area and Severity Index (EASI) for AD, along with QoL assessments such as the Dermatology Life Quality Index (DLQI) and numerical rating scales for itch (p-NRS) and sleep (s-NRS) at baseline, 16 weeks, and 52 weeks.

The results showed that:

Omalizumab led to a significant reduction in UAS7 scores by 71.9% at 16 weeks and 75.3% at 52 weeks, alongside improvements in c-DLQI.
Dupilumab resulted in a 75.3% decrease in EASI scores, a 40% reduction in p-NRS, and a 52.9% decrease in s-NRS over 52 weeks, with the c-DLQI improving by 72.6%.
There were no severe adverse events reported, and mild reactions included injection-site redness and respiratory symptoms.

In conclusion, both omalizumab and dupilumab proved to be effective in reducing disease severity and enhancing QoL for pediatric patients with CSU and AD, demonstrating a favorable safety profile that suggests their potency as critical treatment options for these conditions.

Source: Galletta F, Rizzuti L, Passanisi S, Rosa E, Caminiti L, Manti S. Efficacy and Safety of Omalizumab and Dupilumab in Pediatric Patients with Skin Diseases: An Observational Study. Journal of Personalized Medicine. 2025;15(2):64. https://doi.org/10.3390/jpm15020064.

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