Children with atopic dermatitis experience hindered growth compared to peers: PEDISTAD trial

The study showed that children with eczema have a lower mean height and higher mean weight and body mass index (BMI) than the study’s reference healthy population. The findings may be informed by several factors, including impacted sleep or prolonged use of growth-affecting therapies for treating atopic dermatitis.

PEDISTAD is an ongoing, international, observational study for patients aged <12 years with moderate-to-severe AD. The study findings were presented at the American Academy of Dermatology (AAD) 2024 Annual Meeting in San Diego, CA.

Atopic dermatitis may impact children’s growth, particularly those who have received topical immunosuppressants and corticosteroids. Analysis of weight, height, and BMI of children with AD compared to the general population could characterize the impact of AD on childhood growth.

In the analysis, Amy S. Paller, MD, chair of dermatology at Northwestern Medicine, and colleagues provided a report on the height, weight, and BMI of enrolled children compared to the general standardized healthy population.

In total, 1329 children were enrolled in PEDISTAD. The analysis assessed the percentage of patients above the 50th percentile and the mean percentiles for weight, height, and BMI at baseline against the CDC Learning Management System reference healthy population, by age in months.

The study led to the following findings:

• Compared with the age-specific population norms, in the PEDISTAD study, at baseline, 50% of males were above the 50th percentile for weight, but only 38% were above for height.
• In females, these figures were 51% and 52% respectively.
• In patients aged 5 to 12 years, only 28% of males and 47% of females were above the 50th percentile for height.
• For BMI, 69% of males and 71% of females were above the 50th percentile.
• The average across all age-specific percentiles for height, weight, and BMI were the 46th, 51st, and 58th for males; and 50th, 50th, and 59th for females in the PEDISTAD population.

In conclusion, the findings showed that moderate-to-severe AD may hinder growth in children below 12 years, possibly due to factors like prolonged use of systemic or topical glucocorticoids and immunosuppressants.

"Early intervention with effective targeted therapies may mitigate the negative impact on growth," the researchers concluded.

Reference:

Paller AS, Geng B, Irvine A, Siegried E, et al. Growth Analysis in Children Aged Less Than 12 Years with Moderate-to-Severe Atopic Dermatitis. Paper presented: American Academy of Dermatology (AAD) 2024 Annual Meeting. March 8 – 12, 2024. San Diego, CA.