Design: Multicentre prospective registry cohort (BioDay)
Population: 309 children aged 6 months to 16 years with moderate-to-severe atopic dermatitis
Primary outcome: EASI, itch, quality of life, adverse events and drug survival to 3 years
Effect: Mean EASI 3.4 at 3 years; drug survival 80.1%; ocular surface disease 36.6%

The Dutch BioDay registry, published 16 September in JAMA Dermatology, followed 309 children aged 16 or under with moderate-to-severe atopic dermatitis who started dupilumab at seven hospitals between 2019 and 2025.

Disease control was maintained: mean EASI was 3.4 and itch score 3.6 out of 10 at three years. Three-year drug survival was 80.1%. Of the 16.2% who stopped, the main reasons were ineffectiveness (38%), adverse events (30%) and administration problems (22%), mostly within the first 18 months. Ocular surface disease was the most frequent adverse event, in 36.6% of children. Children under six had more itch and poorer quality of life than older children, and stopped more often because of injection difficulties.

This is observational real-world data without a comparison group, but three years of sustained control with a predictable adverse-event profile is reassuring for parents weighing a long-term biologic.

Tell parents that most children on dupilumab stay well controlled at three years.
Warn about eye symptoms: about one child in three developed ocular surface disease.
Ask about redness, itching or watering eyes at every visit and refer early to ophthalmology.
Anticipate injection difficulties in under-sixes and plan support for families.

Why it matters

Gives parents long-term data to weigh against years of topical steroids and flares.

The statistics, in plain English

Drug survival of 80.1% means eight in ten children were still on treatment at three years. Without a control group, the study cannot say how many would have improved anyway.