Cited by 343Dermatology and Skin DiseasesAsthma and respiratory diseasesPsoriasis: Treatment and Pathogenesis

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Dupilumab: A review of its use in the treatment of atopic dermatitis

Gooderham, Melinda J., Hong, H. Chih-ho, Eshtiaghi, Panteha, Papp, Kim A.·2018·Journal of the American Academy of Dermatology

DOI 10.1016/j.jaad.2017.12.022

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Abstract

Atopic dermatitis (AD) is a chronic, pruritic immune-mediated inflammatory dermatosis characterized by a T helper 2 (Th2) immune response phenotype and may be associated with systemic inflammation. Dupilumab is an interleukin 4 (IL-4) receptor α-antagonist that inhibits IL-4 and IL-13 signaling through blockade of the shared IL-4α subunit. Blockade of IL-4/13 is effective in reducing Th2 response. Dupilumab has recently been approved in the United States and Europe for the treatment of adult patients with moderate-to-severe AD. Clinical trials have shown that adults with moderate-to-severe AD who receive weekly or biweekly dupilumab injections have significantly improved clinical and patient-reported outcomes, including Eczema Area Severity Index, SCORing Atopic Dermatitis, Dermatology Life Quality Index, and itch Numeric Rating Scale scores. Concomitant use of topical corticosteroids along with dupilumab results in a greater improvement in signs and symptoms of AD than with use of dupilumab alone. Biomarker analyses show that dupilumab modulates the AD molecular signature and other Th2-associated biomarkers. Common adverse events reported in the clinical trials were nasopharyngitis, upper respiratory tract infection, injection site reactions, skin infections, and conjunctivitis. These were mild-to-moderate in nature, and overall rates of adverse events occurred with similar frequency between the treatment and placebo groups. There were no significant serious safety concerns identified in phase III clinical trials. Dupilumab, as monotherapy or with concomitant use of topical corticosteroids, can significantly improve clinical outcomes and quality of life in patients suffering from moderate-to-severe AD. Ongoing studies of dupilumab will help determine the clinical efficacy and safety profile of its long-term use.

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Background
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Gavrilita, E., Silion, S., Bîtcă, M., & Tatu, A. L. (2024) · Clinical Cosmetic and Investigational Dermatology · doi:10.2147/ccid.s459096 · Cited by 4
“38 A retrospective study compared the efficacy of dupilumab on patients with iAD and eAD.”
Background
Dupilumab for the treatment of moderate and severe atopic dermatitis: real-life experience
Sroka-Tomaszewska, J., Bulińska, B., Wilkowska, A., Nowicki, R. J., & Trzeciak, M. (2023) · Advances in Dermatology and Allergology · doi:10.5114/ada.2023.133818 · Cited by 4
“The main immune disorders are characterised by the overexpression of Th2 cytokines (T helper type 2 cells) such as interleukins: IL-4, IL-5, and IL-13, and chemokines CCL17, CCL18, and CCL22 [5].”
Background
Room temperature quantitative liquid concentration device and application to interleukins analysis in a B-cell culture medium
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“…quality of life of patients that are used for investigation in clinical trials on atopic dermatitis: Eczema Area and Severity Index (EASI), Scoring Atopic Dermatitis (SCORAD), Dermatology Life Quality Index (DLQI), Numeric Rating Scale (NRS), and Hospital Anxiety and Depression Scale (HADS) [4,5].”
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Influential
Dupilumab in Atopic Dermatitis
Lázaro‐Sastre, M., Garcı́a-Sánchez, A., Gómez‐Cardeñosa, A., & Davila, I. J. (2019) · Current Treatment Options in Allergy · doi:10.1007/s40521-019-00218-x · Cited by 3
Dupilumab for Atopic Dermatitis—From Clinical Trials to Molecular and Cellular Mechanisms
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Past, Present, and Future of Pediatric Atopic Dermatitis Management
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Early Adoption of Dupilumab in the Medicare Population in 2017.
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IL-1α antibody inhibits dose-dependent exacerbation of eosinophilic inflammation by crude house-dust-mite antigen in the conjunctiva of an atopic keratoconjunctivitis mouse model
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“Dupilumab, a fully human monoclonal antibody for IL-4 receptor α (IL4Rα), inhibits the signaling of both IL-4 and IL-13, and it has shown promising efficacy in the treatment of moderate-to-severe atopic dermatitis.(22) Benralizumab, a humanized monoclonal antibody for IL-5Rα, can reduce asthma exacerbation rate and bl…”
Background
Atopic Dermatitis: Evolution and Revolution in Therapy
Appiah, M. (2021) · Cutis · doi:10.12788/cutis.0337 · Cited by 3
Clinical Characteristics of Super Responders to Anti-IL-4Rα Biologic Therapy in Atopic Dermatitis
Zhang, L., Fang, L., Zhong, K., & Zhou, Y. (2025) · Dermatology and Therapy · doi:10.1007/s13555-025-01514-y · Cited by 2
“Clinical trials have consistently demonstrated its robust efficacy in improving both objective disease severity and subjective symptoms, including pruritus and quality of life [7,8].”
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Won, S., Jeong, N., Choi, Y., Jin, M., Park, H.-H., Lee, S., & Kim, S. (2025) · Immunopharmacology and Immunotoxicology · doi:10.1080/08923973.2025.2550702 · Cited by 2
“…paradigm focuses on developing new immunomodulators, with particular attention devoted to targeted therapies such as il-4 and il-13 inhibitors [8]. however, these therapies are associated with various side effects, including skin atrophy, infections, and a burning sensation [9], high-lighting…”
Eczema: etiology, subtypes, therapeutic approaches and socioeconomic impact
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“Dupilumab also targets downregulates inflammatory mediators and epidermal proliferation, while upregulating structural and epidermal barrier proteins (103).”
Dupilumab Beyond the Airway: Decreased Morbidity in a Real‐World Analysis
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Großzellig-anaplastisches T-Zell-Lymphom und Mycosis fungoides unter der Therapie mit Dupilumab
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“Dupilumab bindet an die α-Untereinheit des Interleukin (IL)4 -Rezeptors, und die Blockade moduliert die Signalübertragung sowohl des IL-4- als auch des IL-13-Signalweges [1].”
BackgroundInfluential
Regression of Metastatic Malignant Melanoma with Dupilumab: A Case Report
Marr, J. H., & Al‐Shammari, A. (2024) · Skin Health and Disease · doi:10.1002/ski2.362 · Cited by 2
An Observational Study of Early Treatment Response and Predictors of Dupilumab in the Treatment of Moderate‐to‐Severe Atopic Dermatitis
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Systems Biology Methods via Genome-Wide RNA Sequences to Investigate Pathogenic Mechanisms for Identifying Biomarkers and Constructing a DNN-Based Drug–Target Interaction Model to Predict Potential Molecular Drugs for Treating Atopic Dermatitis
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“Blocking IL-4/13 can effectively reduce the Th2-mediated immune response [4].”
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“Dupilumab is an IL-4 receptor a-antagonist approved for the treatment of moderate to severe atopic dermatitis and uncontrolled asthma (through its reduction of the TH2 helper T-cell inflammatory response).(42,43) Omalizumab is an IgE antagonist also approved for the treatment of uncontrolled asthma and chronic idiopat…”
Background
Probiotics for Atopic Dermatitis: An Update
Kakade, P., Wairkar, S., Lohakare, S., Shah, P., & Patravale, V. B. (2021) · Springer eBooks · doi:10.1007/978-981-16-5628-6_9 · Cited by 2
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“Dupilumab is a new medication used to treat moderate-to-severe atopic dermatitis (eczema) [3] and can improve dermatitis that is inadequately controlled by topical corticosteroids [3].”
Background
Sex Differences in Clinical Presentation and Management in Eosinophilic Esophagitis
Fogla, R., Glaubitz, E., Bhatia, S., Ravishankar, A., Andy, C., Niec, R. E., & Katz, P. O. (2023) · Foregut The Journal of the American Foregut Society · doi:10.1177/26345161231170590 · Cited by 2
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The less‐known face of dupilumab: its role in mesenchymal stem cells by interleukin‐13 modulation
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Dupilumab-Associated Acquired Hemophilia A in an Elderly Male With Severe Eczema
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“Dupilumab injection was safe in our case report without adverse effects [12] [13].”
Background
The Simultaneous Inhibition of IL‑4 and IL‑13 by Dupilumab
Sanchez, A. P. G., & Fernandes, T. E. A. (2021) · Journal of Clinical Research in Dermatology · doi:10.15226/2378-1726/8/2/001138 · Cited by 1
Therapeutic approach to atopic dermatitis in children
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“증 또는 난치성 아토피피부염 환자에서 심각한 부작용 없이 높은 치료 성적을 보고하여 최근 아토피피부염의 치료에 효 과적으로 사용되고 있는 약제이다[24,25].”
Dupilumab-induced ocular surface disease: a primer
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Interaction between expression of CD23 on B-lymphocytes and level of specific IgE against molecular components of NPC2 family, lipocalins, uteroglobins, and molecular components of molds and yeast
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Authors: Gooderham, M. J., Hong, H. C.-H., Eshtiaghi, P., & Papp, K. A.
Affiliations: Queen's University (CA)
University of British Columbia (CA)
Probity Medical Research (CA)
Corresponding author: Gooderham, Melinda J.
ORCID: Gooderham, Melinda J.
Hong, H. Chih-ho
Eshtiaghi, Panteha
Papp, Kim A.
Venue: Journal of the American Academy of Dermatology
Publisher: Elsevier BV
Published: 2018-03
Volume: 78
Issue: 3
Pages: S28-S36
ISSN: 0190-9622 (ISSN-L)
DOI: 10.1016/j.jaad.2017.12.022
OpenAlex: W2789024274
Cited by: 343
References: 17
Citations by year: 2026: 30 · 2025: 39 · 2024: 40 · 2023: 41 · 2022: 47 · 2021: 64 · 2020: 43 · 2019: 28 · 2018: 10
FWCI: 39.26
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Journal of the American Academy of Dermatology (publishedVersion)
PubMed (publishedVersion)
Funders: Bayer
LEO Pharma
Sanofi
Topics: Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Asthma and respiratory diseases
Life Sciences › Immunology and Microbiology › Immunology › Psoriasis: Treatment and Pathogenesis
Keywords: dupilumab, atopic dermatitis, IL-4 receptor alpha antagonist, IL-4/IL-13 signaling, Th2 immune response, topical corticosteroids, biomarkers, adverse events, quality of life, moderate-to-severe atopic dermatitis
MeSH terms: Patient Reported Outcome Measures, Antibodies, Monoclonal, Biological Products, Dermatitis, Atopic, Female, Humans, Male, Quality of Life, Severity of Illness Index, Drug Delivery Systems, Treatment Outcome, Clinical Trials, Phase III as Topic, Risk Assessment, Antibodies, Monoclonal, Humanized

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Dupilumab: A review of its use in the treatment of atopic dermatitis

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