Amy S. Paller, MD: PEDISTAD Trial Explores Bone Health in Children With Atopic Dermatitis

“Take bone health very seriously,” Amy S. Paller, MS, MD, advised colleagues in an exclusive interview with Dermatology Times. Paller is chair in the department of dermatology, director of Skin Biology and Diseases Resource-Based Center, and the Walter J. Hamlin Professor of Dermatology at Northwestern University Feinberg School of Medicine. Paller was also the lead author of “Growth Analysis in Children Aged Less Than 12 Years with Moderate-to-Severe Atopic Dermatitis,”¹ the poster that received first place at the 2024 American Academy of Dermatology Annual Meeting in San Diego.

Paller shared insights from the PEDISTAD (NCT03687359) trial, which is an ongoing observational 10 year international study of 1329 children under 12 years old with moderate to severe atopic dermatitis that is inadequately controlled by topical therapies and are candidates for systemic medications.2 About half of the participants are male (53.2%). More than half of the patients are White (59.0%), followed by Asian (24.3%), and Black (9.9%); 5.5% identified as “other” and 1.3% as indigenous. The mean age of participants is 6 years, with the youngest patient 0.3 years and the oldest 11 years.

Using the Centers for Disease Control Learning Management System, Paller and colleagues compared the percentage of participants who scored above the 50th percentile and the mean percentiles for height, weight and body mass index at baseline against similarly aged healthy individuals.

“Overall, children with moderate-to severe AD had a higher mean weight and BMI, and lower mean height than the reference healthy population,” the poster authors found. “Moderate-to-severe AD may hinder growth in children aged <12 years, possibly due to factors like sleep deprivation, prolonged use of topical or systemic glucocorticoids and immunosuppressants. Early intervention with effective targeted therapies may mitigate the negative impact on growth.”

The research, although it is early, is very exciting, Paller told Dermatology Times, and already lends important notes for practicing dermatologists. “In my clinics, I'm making sure to get weight and height measurements on children when they come in for visits and to make that part of my tracking. We’re not just looking at how they're doing in terms of the erythema, the scaling, the itch, the pain, the sleep, but also looking at how they're doing in their growth,” Paller said. “we really need to be following our patients to consider bone health and linear growth as an important component in how we can change their lives.”

References

1. Paller AS, Geng B, Irvine A, et al. Growth Analysis in Children Aged Less Than 12 Years with Moderate-to-Severe Atopic Dermatitis. Poster presented at the 2024 American Academy of Dermatology Annual Meeting; March 8 – 12, 2024; San Diego, CA.

2. Observational Evaluation of Atopic Dermatitis in Pediatric Patients (PEDISTAD). ClinialTrials.gov identifier: NCT03687359. Update December 15, 2024. Accessed April 1, 2024. https://clinicaltrials.gov/study/NCT03687359