Dupilumab‐associated hypereosinophilia in patients treated for moderate‐to‐severe atopic dermatitis

Marcant, Pierre; Balaye, Pierre; Merhi, Ribal; Jendoubi, Fatma; Nosbaum, Audrey; Raison‐Peyron, Nadia; Du-Thanh, A.; Lasek, A.; Bouëdec, M.C. Ferrier Le; Tétart, F.; Valois, A.; Barbarot, S.; Soria, Angèle; Staumont‐Sallé, D.

doi:10.1111/jdv.17177

Cited by 19 publications

(14 citation statements)

References 8 publications

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“…It should be noted that blood eosinophilia was reported in 4 to 25% of patients in the dupilumab group compared to 0.6% in the placebo group 173,176 . This paradoxical effect has also been reported in patients treated with dupilumab for moderate-to-severe atopic dermatitis 177 .…”

Section: Dupilumabsupporting

confidence: 55%

Biologics and Airway Remodeling in Severe Asthma

Varricchi

Ferri

Pepys

et al. 2022

Preprint

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Asthma is a chronic inflammatory airway disease resulting in airflow obstruction, which in part can become irreversible to conventional therapies, defining the concept of airway remodeling. The introduction of biologics in severe asthma has led in some patients to the complete normalization of previously considered irreversible airflow obstruction. This highlights the need to distinguish a “fixed” bronchial obstruction due to structural changes unresponsive to current therapies, from a “reversible” one as demonstrated by lung function normalization during biological therapies not previously obtained even with high dose systemic glucocorticoids. The mechanisms by which exposure to environmental factors initiates the inflammatory responses that trigger airway remodeling are still incompletely understood. Alarmins represent tissue-derived cytokines that initiate immunologic events leading to inflammatory airway remodeling. Biological therapies can improve airflow obstruction by addressing these airway inflammatory changes. In addition, biologics might prevent and possibly even revert “fixed” remodeling due to structural changes. Hence, it appears clinically important to separate the therapeutic effects (early and late) of biologics as a new paradigm to evaluate the effects of these drugs and future treatments on airway remodeling in severe asthma.

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Section: Dupilumabsupporting

confidence: 55%

Biologics and Airway Remodeling in Severe Asthma

Varricchi

Ferri

Pepys

et al. 2022

Preprint

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“… 3 , 5 This was not observed in clinical trials of AD but was recently demonstrated in a retrospective cohort. 9 In post–Food and Drug Administration approval studies of asthma, hypereosinophilia was considered asymptomatic, although there have been case reports of hypereosinophilia leading to adverse events. 3 , 10 In a recently reported case of eosinophilic vasculitis that developed in a patient with asthma treated with dupilumab, the investigators concluded that the prominent perivascular eosinophilic infiltrate suggested the pathologic role of eosinophils and not the biologic itself.…”

Section: Discussionmentioning

confidence: 99%

Dupilumab-induced erythema nodosum

Mustin

Cole²,

Blalock³

et al. 2022

JAAD Case Reports

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“…This developed around 2.5 months after dupilumab initiation and although no clinical signs of organ involvement were detected, 25% of patients with hypereosinophilia discontinued therapy. those who continued, absolute eosinophil counts trended downwards with time [70].…”

Section: Dupilumabmentioning

confidence: 91%

Adverse Reactions to Biologic Medications Used in Allergy and Immunology Diseases

Chow

Franzblau

Khan

2022

Curr Allergy Asthma Rep

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Purpose of ReviewThe use of biologic therapies has risen exponentially over recent years, allowing for unprecedented disease control within numerous areas of Allergy/Immunology. With this expanded use, awareness and understanding of adverse reactions to biologic agents have also increased. Recent Findings Multiple biologic adverse reaction phenotypes have been described, but significant overlap in clinical features across phenotypes exists. Given considerable phenotypic overlap, a targeted testing approach may not always be clear, and more recent classifications focus on management decision making using tools of diagnostic challenges and rapid drug desensitizations, guiding clinicians in developing a management plan when the exact underlying mechanism is not clearly known. With increased clinical experience with omalizumab, mepolizumab, reslizumab, benralizumab, dupilumab, tezepelumab, rituximab, and TNF-inhibitors, there is a growing appreciation to the spectrum and particularities of adverse reactions to these agents which are outlined in this review. Summary Our understanding of the clinical presentation and management of adverse reactions to biologic medications encountered in Allergy/Immunology has grown. Opportunities remain to further define optimal diagnostic and management strategies for these reactions.

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Dupilumab‐associated hypereosinophilia in patients treated for moderate‐to‐severe atopic dermatitis

Cited by 19 publications

References 8 publications

Biologics and Airway Remodeling in Severe Asthma

Biologics and Airway Remodeling in Severe Asthma

Dupilumab-induced erythema nodosum

Adverse Reactions to Biologic Medications Used in Allergy and Immunology Diseases

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