'It was like a little family': A qualitative study of online hearing voices peer support groups in the NHS.

Atopic dermatitis (AD) affects up to 20% of the paediatric population []. Patients with severe AD may respond sub‐optimally to conventional therapies, including topical corticosteroids (TCS) and topical calcineurin inhibitors. Poorly controlled AD can cause long‐term negative effects on the child's physical and mental health [, , ]. Escalation of therapy to systemic immunomodulators such as methotrexate, azathioprine, cyclosporin, and mycophenolate mofetil can have significant side effects []. Dupilumab is a novel anti‐IL‐4 receptor (IL‐4Rα) monoclonal antibody that suppresses IL‐4 and IL‐13 signalling pathways, hence inhibiting T helper type 2 (Th2) inflammation []. Previous large randomised controlled trials (RCTs) have demonstrated its efficacy and safety in treatment‐resistant paediatric AD [, , , , , ]. However, as RCTs may not fully reflect the complexities of real‐world practice [], real‐world data that captures diverse cohorts with long follow‐up may provide relevant insights for clinicians and patients. A recent Australian study investigated the real‐world clinical profile of dupilumab in paediatric AD, demonstrating significant clinical improvements with an acceptable safety profile []. There is still, though, a lack of data describing the differences in efficacy and safety outcomes between age groups.