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Dupilumab: A review of its use in the treatment of atopic dermatitis
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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“This dampens the T H 2 inflammatory response, thereby improving the symptoms associated with atopic dermatitis.1,2”
From Dupilumab for Allergic Contact Dermatitis: An Overview of Its Use and Impact on Patch Testing. (2022) · cites this paper as [2]
In the citing paper
“Through inhibition of the IL-4Rα subunit, it prevents activation of the IL-4/IL-13 signaling cascade.”
From Dupilumab for Allergic Contact Dermatitis: An Overview of Its Use and Impact on Patch Testing. (2022) · cites this paper as [2]
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Self-citationEczema Prevalence in the United States: Data from the 2003 National Survey of Children's Health
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Interleukin‐13: Targeting an underestimated cytokine in atopic dermatitis
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JAK–STAT signaling pathway in the pathogenesis of atopic dermatitis: An updated review
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“Dupilumab, an inhibitor of both IL-4 and IL-13 signaling, is used in clinical settings.(39,40) Nemolizumab, an inhibitor of IL-31 signaling, has received attention for its antipruritic effect.”
BackgroundObesity alters pathology and treatment response in inflammatory disease
Bapat, S. P., Whitty, C., Mowery, C. T., Liang, Y., Yoo, A., Jiang, Z., Peters, M. C., Zhang, L., Vogel, I. A., Zhou, C., et al. (2022) · Nature · doi:10.1038/s41586-022-04536-0 · Cited by 243
Metadata
- 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.
- 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)
- 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
- 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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