Treatment of Severe Atopic Dermatitis with Dupilumab in Three Patients with Renal Diseases

Abstract

Background: Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease that can affect patients’ quality of life. Dupilumab is the first biologic agent approved for the treatment of patients with inadequately controlled moderate-to-severe AD and its mechanism of action is based on the inhibition of the interleukin (IL)-4 and IL-13 signaling. There are only a few data on the safety of dupilumab in AD patients with comorbidities, including kidney disorders. Materials and Methods: Descriptive retrospective series of three patients with chronic kidney diseases (Alport syndrome, IgA nephropathy, and hypertensive nephrosclerosis, respectively) receiving dupilumab for their concomitant severe AD. Results: Treatment with a standard dosage of dupilumab caused a relevant improvement of AD in all patients without any adverse events or worsening of renal function. In a patient with severe renal failure, the drug was effective and well tolerated without the need for any dose adjustments, also after the initiation of peritoneal dialytic treatment. Conclusion: Our case series suggests the use of dupilumab as an effective and safe treatment for AD patients suffering from renal diseases, although additional studies are required to confirm such preliminary findings.

Pemphigoid diseases in patients with end-stage kidney diseases: pathogenesis and treatment

“…Rituximab, a B-cell depleting drug, has demonstrated efficacy in improving acute antibody-mediated renal transplant rejection (AMR), although its therapeutic effect in chronic AMR remains insignificant ( 91 ). Dupilumab has been utilized in nine patients with renal insufficiency as a safe and effective drug for various skin conditions, including atopic dermatitis, reactive perforating collagenosis, and uremic pruritus ( 92 – 95 ). Its potential use in patients with concurrent pemphigoid diseases and ESKD is promising.…”