皮膚科 濕疹、富貴手、小孩異膚

異膚女童長高針:從三個月大開始

從三個月大開始,小朋友便與異位性皮膚炎為伴。然而,命運的轉折點在她四歲時悄然來臨。那時,她開始接受Dupixent的治療。

更新於 2025年4月25日 異位性皮膚炎生物製劑論文導讀

排版式文字封面,米白底,左上角有綠色短線與「皮膚科」標示,副標提到小朋友從三個月大就與異位性皮膚炎為伴、四歲時出現轉折,左下角署名張宏嘉醫師。
本篇分成 5 段
  1. 研究背景與重點發現
  2. 具體數據
  3. 機轉與臨床意義
  4. 臨床建議
  5. 結論

從三個月大開始,小朋友便與異位性皮膚炎為伴。然而,命運的轉折點在她四歲時悄然來臨。那時,她開始接受Dupixent的治療。今天,是她第八次注射這針劑,我和她的媽媽、阿嬤都驚訝地發現,她的身高似乎在不經意間拔高了許多。

這個意外的驚喜不僅在我們的診所被觀察到,也在國際文獻中得到了印證。看到這樣的結果,我們感到無比欣慰和激勵。

在這裡,我也要特別感謝診所的同仁們,感謝她們的支持與包容,願意讓我在醫學美容診的時間治療健保疾病的病人。這份善意與合作,使得我們能夠共同見證這位小朋友的健康成長。願她在未來的日子裡,能夠更加健康、快樂地迎接生命中的每一個美好時刻。

研究背景與重點發現

  • 嚴重異位性皮膚炎(AD)會影響兒童的身高發育,這些孩子常見身高低於同齡健康兒童的生長曲線百分位數,並且體重和BMI(身體質量指數)偏高[3][6]。
  • 近期多項國際臨床試驗(如LIBERTY AD PEDS)證實,針對6-11歲嚴重異位性皮膚炎兒童,使用Dupixent治療16週後,明顯提升了低於正常生長曲線的兒童的身高百分位數,尤其對於原本身高處於較低百分位(如25%、30%、40%)的族群效果最為顯著[1][2][3][4][5][6]。

具體數據

  • 在治療前身高低於第25百分位的兒童中,接受Dupixent治療後有30.6%的人身高提升超過5個百分位,而安慰劑組僅11.9%[1][2][3][4][5][6]。
  • 在第30百分位,Dupixent組為31.9%,安慰劑組為11.1%;在第40百分位,Dupixent組為31.3%,安慰劑組為15.5%(上述皆具統計顯著性)[1][2][3][4][5][6]。
  • 若以第50百分位作為基準,雖然Dupixent組提升比例(29%)高於安慰劑組(15.7%),但統計上未達顯著差異[1][2][3][4][5][6]。
  • 女童治療效果尤為明顯,36.7%接受Dupixent的女童身高提升超過5個百分位,而安慰劑僅1.3%;男童分別為25%與5%[4]。

機轉與臨床意義

  • 嚴重異位性皮膚炎會導致慢性炎症,影響骨骼發育與生長激素作用,進而抑制身高成長[3][6]。
  • Dupixent有效控制異位性皮膚炎的炎症反應,讓兒童能「追趕」生長曲線,特別是在生長潛力尚未耗盡的低百分位兒童身上效果最明顯[3][5][6]。
  • 研究也發現,Dupixent會提升血清骨鹼性磷酸酶(bone ALP)水平,這與骨骼生長活性提升有關,但詳細機制仍在研究中[2][3]。

臨床建議

  • 對於因嚴重異位性皮膚炎導致生長受限的兒童,及早且有效地使用Dupixent治療,不僅能改善皮膚症狀,還有助於身高追趕成長,可能帶來長遠的健康益處[2][3][5][6]。
  • 對於身高明顯落後於同齡兒童(低於第40百分位)的患者,治療成效最為明顯[1][2][3][5][6]。

「這些數據支持了嚴重異位性皮膚炎兒童在接受Dupixent治療後,能夠顯著改善身高生長,尤其是原本生長受限的孩子。」——歐洲皮膚科學會年會報告[3]

結論

Dupixent注射對於因嚴重異位性皮膚炎導致身高受限的兒童,能顯著促進身高追趕成長,尤其對於原本身高百分位較低的孩子效果最為明顯。及早有效治療異位性皮膚炎,不僅改善皮膚狀況,還有助於兒童的整體生長發育[1][2][3][4][5][6]。

引用:

[1] Could dupilumab help improve height in children with severe atopic… https://touchderma.com/insight/could-dupilumab-help-improve-height-in-children-with-severe-atopic-dermatitis/

[2] [PDF] Abstract N°: 8073 Growth analysis in children aged 6 to 11 years… https://s3.eu-central-1.amazonaws.com/m-anage.com.storage.eadv/abstracts_congress_2024/49547.pdf

[3] Children With Severe AD Catch Up on Growth With Dupilumab https://www.medscape.com/viewarticle/children-severe-ad-catch-growth-dupilumab-2024a1000ivo

[4] Dupilumab May Improve Growth in Children with Severe Atopic… https://www.hcplive.com/view/dupilumab-may-improve-growth-children-severe-atopic-dermatitis-16-weeks

[5] Biologic May Spark Catch-Up Growth in Kids With Eczema https://www.medpagetoday.com/meetingcoverage/aaaai/114498

[6] Maui Derm News: Kids With Severe AD Catch Up on Growth With… https://thedermdigest.com/maui-derm-news-kids-with-severe-ad-catch-up-on-growth-with-dupilumab/

[7] Growth analysis among adolescents with moderate-to-severe atopic… https://pmc.ncbi.nlm.nih.gov/articles/PMC9478921/

[8] Positive Dupixent® (dupilumab) Phase 3 Data in Children Aged 6… https://investor.regeneron.com/news-releases/news-release-details/positive-dupixentr-dupilumab-phase-3-data-children-aged-6-months

[9] Dupixent® (dupilumab) Significantly Reduced Severe Asthma… https://www.prnewswire.com/news-releases/dupixent-dupilumab-significantly-reduced-severe-asthma-attacks-in-children-and-is-the-only-biologic-to-demonstrate-improvement-in-childrens-lung-function-in-a-randomized-phase-3-trial-301150713.html

[10] Dupilumab increases levels of bone growth biomarker irrespective… https://academic.oup.com/bjd/article/191/Supplement_2/ljae266.050/7728651

[11] Frequently Asked Questions About DUPIXENT® (dupilumab) https://www.dupixent.com/frequently-asked-questions

[12] [PDF] PRODUCT MONOGRAPH INCLUDING PATIENT MEDICATION… https://www.sanofi.com/assets/countries/canada/docs/products/prescription-products/dupixent-en.pdf

[13] Adverse effects of dupilumab in a child with atopic dermatitis https://www.sciencedirect.com/science/article/pii/S2949913525000072

[14] Dupixent (dupilumab) side effects and what to do about them https://www.medicalnewstoday.com/articles/drugs-dupixent-side-effects

[15] DUPIXENT® (dupilumab) Pediatric EoE Safety Profile https://www.dupixenthcp.com/eoe/efficacy-safety/children-safety-data

[16] Long-term real-world experience of the side effects of dupilumab in… https://pubmed.ncbi.nlm.nih.gov/35238115/

[17] Dupixent Side Effects: What They Are and How to Manage Them https://www.healthline.com/health/drugs/dupixent-side-effects

[18] Child Clinical Study Design | DUPIXENT® (dupilumab) https://www.dupixenthcp.com/atopicdermatitis/efficacy-safety/children-study-designs

[19] Children IGA Efficacy Results | DUPIXENT® (dupilumab) https://www.dupixenthcp.com/atopicdermatitis/efficacy-safety/children-iga-clinical-trial

[20] A phase 2, open‐label study of single‐dose dupilumab in children… https://pmc.ncbi.nlm.nih.gov/articles/PMC7894166/

[21] The effect of atopic dermatitis in pediatric patients on height - PubMed https://pubmed.ncbi.nlm.nih.gov/38013381/

[22] The effect of atopic dermatitis in pediatric patients on height - LWW https://journals.lww.com/md-journal/fulltext/2023/11240/the_effect_of_atopic_dermatitis_in_pediatric.125.aspx

[23] Dupilumab in the treatment of AD in infants and children | DDDT https://www.dovepress.com/a-review-of-dupilumab-in-the-treatment-of-atopic-dermatitis-in-infants-peer-reviewed-fulltext-article-DDDT

[24] Infections in Children Aged 6 Months to 5 Years Treated… - PubMed https://pubmed.ncbi.nlm.nih.gov/38267692/

[25] Early Dupilumab Response Predicts Pediatric Atopic Dermatitis… https://liebertpub.com/doi/full/10.1089/derm.2024.0160?doi=10.1089%2Fderm.2024.0160

[26] Study: Dupixent Improves AD Symptoms in Kids As Young As Six… https://practicaldermatology.com/news/study-dupixent-improves-ad-symptoms-in-kids-as-young-as-six-months/2460898/

[27] Dupilumab Treatment in Pediatric Patients Aged 6–11 Years with… https://pmc.ncbi.nlm.nih.gov/articles/PMC10849907/

[28] Results in Children 6 + Years with Eczema | DUPIXENT® (dupilumab) https://www.dupixent.com/atopicdermatitis/dupixent-results/children

[29] Child Clinical Trial Safety Profile | DUPIXENT® (dupilumab) https://www.dupixenthcp.com/atopicdermatitis/efficacy-safety/children-safety-clinical-trial

[30] Results in Young Children with Eczema | DUPIXENT® (dupilumab) https://www.dupixent.com/atopicdermatitis/dupixent-results/infants

[31] The Application of Dupilumab to Pediatric Patients Aged 6–11yrs… https://pmc.ncbi.nlm.nih.gov/articles/PMC10162094/

[32] Dupixent® (dupilumab) Positive Phase 3 Data in Children 1 to 11… https://newsroom.regeneron.com/news-releases/news-release-details/dupixentr-dupilumab-positive-phase-3-data-children-1-11-years

[33] Dupixent® (dupilumab) Positive Phase 3 Data in Children 1 to 11… https://investor.regeneron.com/news-releases/news-release-details/dupixentr-dupilumab-positive-phase-3-data-children-1-11-years

[34] Pediatric Patients with Eosinophilic Esophagitis Administered… https://www.appliedclinicaltrialsonline.com/view/pediatric-patients-eosinophilic-esophagitis-dupixent-significant-improvements-multiple-disease-measures

[35] Press Release: Dupixent® (dupilumab) Phase 3 trial shows positive… https://www.sanofi.com/en/media-room/press-releases/2022/2022-07-14-05-00-00-2479427

原臉書貼文的標籤 #異膚女童長高針

重要聲明

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