Dupilumab in the treatment of moderate-to-severe atopic dermatitis: A focused review

Abstract

Atopic dermatitis (AD) is a chronic inflammatory skin condition causing significant decline in quality of life. Moderate-to-severe AD is refractory to first-line topical therapy, while systemic immunosuppressants can have significant adverse effects. Dupilumab is a fully human monoclonal antibody and the first food and drug administration approved biologic therapy for the treatment of adults with moderate-to-severe AD. It inhibits the actions of both interleukin (IL)-4 and IL-13, two T helper cell type 2 cytokines involved in the pathogenesis of AD. Dupilumab has been found to be an efficacious treatment option in AD with its main adverse reactions being conjunctivitis, injection site reaction, and facial redness. Dupilumab is known to improve the severity and extent of AD, as measured by the eczema area severity index and dermatology life quality index. A similar observation was made by the authors in 30 patients. Thus, dupilumab represents a valuable new treatment option for moderate-to-severe AD, however, high cost remains a major consideration.

Facial erythema in patients with atopic dermatitis treated with Dupilumab – a descriptive study of morphology and Aetiology

“…[1][2][3] Previous studies reported facial erythema occurred in approximately 4-10% of patients treated with dupilumab with the mean onset of 8-22 weeks. [5][6][7][8][9][10][11] Facial involvement of dermatitis carries a profound psychosocial burden. 12,13 Indeed, some patients stopped dupilumab therapy on account of this adverse event, despite the beneficial effects on the rest of the body.…”

“…Facial erythema was not reported as an adverse event in the phase 3 clinical trials 1–3 . Previous studies reported facial erythema occurred in approximately 4–10% of patients treated with dupilumab with the mean onset of 8–22 weeks 5–11 . Facial involvement of dermatitis carries a profound psychosocial burden 12,13 .…”