Dupilumab effectiveness for the treatment of patients with concomitant atopic dermatitis and chronic rhinosinusitis with nasal polyposis

Abstract

Dupilumab is a fully human monoclonal antibody targeting interleukin (IL) 4 and IL13 pathways. We performed a retrospective observational study to evaluate the efficacy of dupilumab for the treatment of adult patients referred to our department, from January 2019 to May 2021, with a diagnosis of moderate to severe atopic dermatitis (AD) and concomitant chronic rhinosinusitis with nasal polyps (CRSwNP), with a clinical indication for dupilumab treatment. Skin disease activity was assessed using EASI, Numerical Rating Scale (NRS) for pruritus (P-NRS) and sleep (S-NRS), and Dermatology Life Quality Index (DLQI). The CRSwNP activity was evaluated using 22-item Sino-Nasal Outcome Test (SNOT-22), endoscopic nasal polyp score (ENPS), nasal congestion or obstruction score (scale 0-3), loss-of-smell score (scale 0-3), and rhinosinusitis disease severity (visual analog scale 0-10 cm). A significant improvement of all the score values was recorded assessing patients at baseline, week (W)16, and W24. In particular, concerning the CRSwNP, a reduction of ENPS score (baseline:

A 24‐weeks real‐world experience of dupilumab in adolescents with moderate‐to‐severe atopic dermatitis

“…Dupilumab is a monoclonal antibody approved for the treatment of moderate‐to‐severe AD in patients aged ≥6 years 4 . It blocks the shared receptor component for interleukin (IL)‐4 and IL‐13, thus inhibiting the signal of these two key drivers of type 2 inflammation 5–7 . In large, double‐blind, randomized, placebo‐controlled trials, dupilumab therapy showed to be effective and safe for adolescents 8,9 .…”

Cutaneous Reactions Following COVID-19 Vaccination: A Review of the Current Literature

“… 84 Moreover, undergoing treatment with dupilumab does not seem to prevent the possibility of a flare of the disease, even if its efficacy and safety have been largely demonstrated. 85 , 86 No data of atopic dermatitis worsening in patients undergoing treatment with janus kinase inhibitors are available. 87 , 88 Concerning hidradenitis suppurativa, there are currently few cases of new-onset disease (n = 1) 89 or disease exacerbation (n = 5).…”

Atopic dermatitis exacerbation after Covid‐19 vaccination in Dupilumab‐treated patients

“…1,2 Atopic dermatitis (AD) is not a contraindication to COVID-19 vaccination and the treatment with dupilumab [a fully human anti-interleukin (IL)-4 receptor alpha monoclonal antibody blocking both IL-4 and IL-13 signalling] seems not to be associated to a reduction in vaccination response. [3][4][5][6] Few cases of AD flare following vaccines administration were reported. 7,8 The aim of this study was to evaluate the frequency and clinical features of AD flare after COVID-19 vaccine administration in AD patients treated with dupilumab.…”

“…2,3 There is a potential association between psoriasis flares-up and COVID-19 vaccination. [4][5][6][7][8][9] There is a report of exacerbation of plaque psoriasis 5 and another report of deterioration of palmoplantar psoriasis 6 after second dose of BNT162b2 COVID-19 mRNA COVID-19 vaccination. In this brief report, we present twelve cases of psoriasis flare up after AZD1222 and BNT162b2 COVID-19 mRNA COVID-19 vaccination in Heraklion, Crete, Greece.…”