ABSTRACT
Rationale: Since 2019, dupilumab has been used to treat severe asthma. Within the severe asthma population, prevalence of anxiety and depression is high. We hypothesize that initiation of dupilumab therapy in children is associated with subsequent reduction in anxiety and depression scores. Methods: Our retrospective study included 33 patients (age 11 to 18;55% female) receiving dupilumab therapy. 18 patients had GAD-7 and PHQ-9 scores available both pre- and post-initiation of dupilumab therapy and were included for analysis. The most recent GAD-7 and PHQ-9 scores prior to dupilumab initiation were compared to those at the first clinic visit after dupilumab initiation. Standard GAD-7 and PHQ-9 severity cutoff scores were used. Results: GAD-7 distribution pre-initiation (vs post-initiation): severe 16.7 % (0%), moderate 5.6% (5.6%), mild 11.1 % (33.3%), minimal 66.7% (61.1%). PHQ-9 distribution pre-initiation (vs post-initiation): severe 0% (0%), moderately severe 5.6 % (0%), moderate 11.1% (5.6%), mild 27.8 % (44.4%), minimal 55.6 % (50%). Change in severity distribution approached significance for both GAD-7 (p=0.08) and PHQ-9 (p=0.07). 9 of the 12 patients who were initiated on dupilumab after the start of the COVID-19 pandemic showed decrease in both GAD-7 and PHQ-9 scores;those results were not statistically significant. Conclusions: Despite our small sample size, our study demonstrates a downtrend in anxiety and depression scores amongst adolescents after initiation of dupilumab therapy. This is particularly notable given the complex psychosocial context of the study period, which included the onset of the COVID-19 pandemic.