Using Dupilumab to Improve Circadian Function, Sleep and Pruritus in Children With Moderate/Severe Atopic Dermatitis

Eligibility Criteria

• * Participants, 6-17 years old at time of enrollment.
• * Moderate to severe chronic AD inadequately controlled by topical treatment, diagnosed according to Hanifin and Rajka criteria by a pediatric dermatologist or allergist.
• * AD severity will be determined at baseline with Validated Investigator Global Assessment (vIGA) score of moderate (3) or severe (4).
• * Patient assessed or parent-proxy (under 8 years old) PROMIS sleep disturbance T-score ≥60.
• * Willing and able to comply with visits and study-related procedures.
• * On stable regimens (consistent use 14 days before Day 1 of study enrollment) of inhaled corticosteroids, topical steroids, and antihistamines.
• * Poorly controlled asthma (Asthma Control Test ≤19).
• * Self-reported sleep disturbance on 2 or more nights in the past 7 days due to allergic rhinitis.
• * Use of concomitant medication that causes scratching.
• * Major medical condition (such as cancer).
• * Active condition that could affect sleep, such as obstructive sleep apnea, restless leg syndrome, insomnia, narcolepsy, severe sleep disordered breathing, severe depression, COVID-19, or hives (urticaria).
• * Having applied topical steroids within 7 days of first or second PSG (important for biomarkers assessment).
• * Use of systemic immunosuppressant within 30 days of first PSG.
• * Having showered or used moisturizers within 12 hours of first or second PSG.
• * Unable to communicate in English (some PROMIS questionnaires not available in translation).
• * Other contraindication to receiving dupilumab (such as history of allergic reaction to dupilumab or any of its components).
• * Pregnancy.
• * Clinical blindness (circadian disturbing).