Dupilumab as a rescue therapy for a chronic urticaria patient who showed secondary failure to omalizumab

Sun, Yng; Lin, Sheng Yiao; Lan, Cheng‐Che E.

doi:10.1002/kjm2.12531

Cited by 9 publications

(4 citation statements)

References 5 publications

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“…Chronic spontaneous urticaria (CSU) entails the absence of identified causes of urticaria and can be highly debilitating and recalcitrant to standard treatments. A total of 14 patients were reported that had failed standard therapies with antihistamines, omalizumab and/or ciclosporin and were subsequently treated with dupilumab (12/14) or a combination of dupilumab and omalizumab (2/14) ( Table 5 ) [ 182 , 183 , 184 , 185 , 186 , 187 , 188 , 189 ]. Complete sustained resolutions were reported in 10/14 patients by clinical evaluation and the 7-day urticaria activity score (UAS7) or urticaria control test (UCT); a UAS7 of 0 was reported in 5 of these cases.…”

Section: Resultsmentioning

confidence: 99%

Dupilumab in Inflammatory Skin Diseases: A Systematic Review

et al. 2023

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Dupilumab was first approved for the treatment of atopic dermatitis (AD) and blocks the signaling of interleukin (IL)-4 and -13. Several other chronic skin conditions share mechanistic overlaps with AD in their pathophysiology, i.e., are linked to type 2 inflammation. Most recently, dupilumab was approved by the U.S. Food and Drug Administration for prurigo nodularis (PN). Given its relatively good safety profile, effective off-label use of dupilumab has been reported for a multitude of dermatologic diseases and several clinical trials for dermatologic skin conditions are currently ongoing. We conducted a systematic review of applications of dupilumab in dermatology other than AD and PN by searching the databases PubMed/Medline, Scopus, Web of Science and Cochrane Library as well as the clinical trial registry ClinicalTrials.gov. We found several reports for effective treatment of bullous autoimmune diseases, eczema, prurigo, alopecia areata, chronic spontaneous urticaria, Netherton syndrome and a variety of other chronic inflammatory skin diseases.

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Section: Resultsmentioning

confidence: 99%

Dupilumab in Inflammatory Skin Diseases: A Systematic Review

et al. 2023

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“…Given the known predominance of type 2 inflammation in CSU, with IL-4 and IL-13 likely contributing to the inflammatory response through their effects on T-cell differentiation and IgE class switching, dupilumab has been postulated as a possible effective treatment in chronic urticaria 58 .…”

Section: Dupilumabmentioning

confidence: 99%

“…In fact, several case reports have shown efficacy in H1-AH and OMA-refractory CSU 58 , some with sustained benefits many months after suspension, suggesting a potential disease-modifying effect of dupilumab in CSU 59 .…”

Section: Dupilumabmentioning

confidence: 99%

Omalizumab and new therapeutic targets in chronic spontaneous urticaria

Pereira,

Xará,

Flor

et al. 2024

PJDV

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Chronic spontaneous urticaria (CSU) is a common and distressing skin disease characterized by itchy wheals, angioedema, or both. There is currently no cure for CSU and symptomatic treatment is often insufficient. Omalizumab, a humanized anti-immunoglobulin (Ig) E monoclonal antibody, remains the only biological drug licensed for CSU, almost a decade after its approval. However, growing knowledge of the pathophysiological mechanisms of this disease has led to recent advances in its treatment, with several drugs in investigation both in pre-clinical and clinical settings. These include biologicals, such as dupilumab (anti-IL-4Rα), secukinumab (anti-IL-17), tezepelumab (anti-TSLP), ligelizumab (anti-IgE), lirentelumab (anti-Siglet 8), and barzovolimab (anti-cKIT), as well as "small molecules," such as Bruton tyrosine kinase (BTK) inhibitors (remibrutinib) and a Mas-related G protein-coupled receptor X2 (MRGPRX2) antagonist. Here, we review the current and future therapeutic options for CSU, based on what is known about the pathogenesis of the disease.

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“…In summary, to our knowledge this is the first report of an adjunctive therapy of dupilumab in combination with omalizumab achieving complete control of clinical symptoms in a patient who had no history of manifest atopic dermatitis. The exact role of IL-4 and IL-13 in CSU is not clear, but these cytokines play a crucial role in IgE class switching, so blockade may be beneficial in CU patients [ 3 , 8 ]. Interestingly, a recent report demonstrated long-term remission in several cases, suggesting a possible disease-modifying effect of dupilumab therapy [ 9 ].…”

Section: Case Reportmentioning

confidence: 99%

Case report: Severe chronic spontaneous urticaria successfully treated with omalizumab and dupilumab

Puxkandl¹,

Hoetzenecker²,

Altrichter³

2023

ALS

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Urticaria is a disease triggered by mast cells and characterized by recurrent symptoms such as wheals and/or angioedema. Most patients benefit from treatment with antihistamines (AH) or, if not effective enough, from additional therapy with omalizumab, which leads to significant symptom relief. Here we present a patient with therapy-resistant chronic spontaneous urticaria treated with AH, omalizumab, and glucocorticosteroids. The subsequent recommended therapy according to the current guideline, cyclosporine A, was contraindicated in this patient. Therefore, therapy with dupilumab was initiated, resulting in a complete control of symptoms. In this case report, we present a case of successful dual therapy with omalizumab and dupilumab.

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Dupilumab as a rescue therapy for a chronic urticaria patient who showed secondary failure to omalizumab

Cited by 9 publications

References 5 publications

Dupilumab in Inflammatory Skin Diseases: A Systematic Review

Dupilumab in Inflammatory Skin Diseases: A Systematic Review

Omalizumab and new therapeutic targets in chronic spontaneous urticaria

Case report: Severe chronic spontaneous urticaria successfully treated with omalizumab and dupilumab

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