Dupilumab use in Atopic Dermatitis may Reduce Risk of Otitis Media and Surgical Interventions: Study

According to a new study, Patients with atopic dermatitis (AD) treated with dupilumab have a lower risk of developing otitis media and needing related surgical procedures compared to those treated with pimecrolimus. The study was published in Pediatric Dermatology journal by Matthew H. and colleagues. The findings highlight dupilumab’s added benefit beyond skin disease management, underscoring its potential to reduce ear-related complications in AD.

This study was a retrospective cohort study that was carried out through the use of the TriNetX research network, a population-based large database. Outcomes between AD patients that received dupilumab and pimecrolimus were compared in the analysis. For comparability, propensity score matching for age at index, current age, sex, race, other atopic diseases, and tobacco smoke exposure was used.

The main outcomes measured were the 5-year risks of all otitis media, nonsuppurative OM, suppurative OM, and future surgical procedures. Cox proportional hazards regression models with 95% confidence intervals (CIs) evaluated relative differences in risk between the two treatment arms. An age-stratified analysis was also conducted to examine specifically children’s risks.

Results

The analysis revealed a reduced risk for dupilumab-treated patients compared to pimecrolimus:

  • All OM: Hazard ratio (HR) 0.60; 95% CI, 0.54–0.67; p < 0.001

  • Nonsuppurative OM: HR 0.60; 95% CI, 0.52–0.70; p < 0.001

  • Suppurative OM: HR 0.61; 95% CI, 0.55–0.69; p < 0.001

  • OM-related surgical procedures: HR 0.73; 95% CI, 0.58–0.90; p = 0.004

  • Notably, comparable reductions in risk were also seen in individuals younger than 18 years, indicating dupilumab has protective effects against complications of OM in all age groups.

This population-based study on a large cohort showed that dupilumab decreases the risk of 5-year otitis media and accompanying surgeries in patients with atopic dermatitis by more than pimecrolimus, with benefits seen consistently in both children and adults. The findings propose that dupilumab can provide additional protection against frequent ENT complications in AD, further endorsing its status as a first-line treatment option.

Reference:

Lanehart, M. H., Hayes, B., Zinn, Z., & Skoner, D. P. (2025). Dupilumab treatment for atopic dermatitis is associated with decreased risk of otitis media and related surgical procedures: A retrospective cohort study. Pediatric Dermatology. https://doi.org/10.1111/pde.16008

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