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Tsai JH, Tsai TF. A Review of Dupilumab-Induced Adverse Events to Dermatologists and the Potential Pathogenesis in the Treatment of Atopic Dermatitis. Dermatitis 2024; 35:24-42. [PMID: 37205852 DOI: 10.1089/derm.2022.0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Dupilumab, a monoclonal antibody targeting interleukin-4 antibody, is approved for use in many type 2 inflammatory diseases, including atopic dermatitis. It is generally well tolerated with no need of routine laboratory monitoring. However, several adverse events have been reported during real-world practice and in pivotal trials. We conducted a systematic literature research of the PubMed, Medline, and Embase databases to identify articles recording the clinical manifestation and potential pathogenesis of these adverse events with interests (AEIs) to dermatologists. In total, 547 cases from 134 studies have developed 39 AEIs 1 day to 2.5 years after dupilumab treatment. The most common AEIs are facial and neck dermatitis (299 cases), psoriasis (70 cases), arthralgia (56 cases), alopecia (21 cases), cutaneous T cell lymphoma (19 cases), severe ocular diseases (19 cases), and drug eruption (6 cases). Most of the AEIs recorded in this review resolved or improved after dupilumab discontinuation or the addition of another treatment, whereas 3 of the cases died of severe AEI. The potential pathogenesis included T help type 1 (Th1)/T help type 2 (Th2) imbalance, Th2/T help type 17 (Th17) imbalance, immune reconstitution, hypersensitivity reaction, transient hypereosinophilia related, and Th1 suppression. Clinicians should be alert of these AEIs for timely diagnosis and appropriate treatment.
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Affiliation(s)
- Jun-Hong Tsai
- From the Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan
| | - Tsen-Fang Tsai
- Department of Dermatology, National Taiwan University Hospital & National Taiwan University, College of Medicine, Taipei, Taiwan
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de Magalhães AR, Machado GU, Lefèvre MA, Garreau AC, Nicolas JF, Vocanson M, Mosnier A, Pralong P, Nosbaum A. T cell-and non T cell-mediated delayed hypersensitivity to dupilumab. J Eur Acad Dermatol Venereol 2023; 37:e1180-e1182. [PMID: 37170927 DOI: 10.1111/jdv.19182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 05/05/2023] [Indexed: 05/13/2023]
Affiliation(s)
- A R de Magalhães
- Serviço de Dermatologia, Universidade Federal da Bahia, Complexo Hospitalar Universitário Professor Edgard Santos, Salvador, Bahia, Brazil
- Serviço de Imunologia, Universidade Federal da Bahia, Complexo Hospitalar Universitário Professor Edgard Santos, Salvador, Bahia, Brazil
| | - G U Machado
- Serviço de Imunologia, Universidade Federal da Bahia, Complexo Hospitalar Universitário Professor Edgard Santos, Salvador, Bahia, Brazil
| | - M A Lefèvre
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France
| | - A C Garreau
- Service d'Allergologie et Immunologie Clinique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - J F Nicolas
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France
- Service d'Allergologie et Immunologie Clinique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - M Vocanson
- Service d'Allergologie et Immunologie Clinique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - A Mosnier
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France
| | - P Pralong
- Department of Dermatology, Allergology and Photobiology, Centre Hospitalier Universitaire Grenoble Alpes, La Tronche, France
| | - A Nosbaum
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France
- Service d'Allergologie et Immunologie Clinique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
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Lemery R, Cariou C, Darrigade AS, Rochefort-Morel C, Carvalho-Lallement P, Tedbirt B, Polard E, Picard S, Bergeron S, Sanchez-Pena P, Dupuy A, Triquet L, Droitcourt C. Immediate hypersensitivity to dupilumab: A French case series. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:2608-2610. [PMID: 37178761 DOI: 10.1016/j.jaip.2023.04.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 03/27/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023]
Affiliation(s)
- Romain Lemery
- Dermatology Department, Rennes University Medical Center, Rennes, France
| | - Claire Cariou
- Dermatology Department, Rennes University Medical Center, Rennes, France; Department of Pulmonology and Allergology, Rennes University Medical Center, Rennes, France
| | | | - Cécile Rochefort-Morel
- Department of Pulmonology and Allergology, Rennes University Medical Center, Rennes, France
| | | | - Billal Tedbirt
- Dermatology Department, Rouen University Medical Center, Rouen, France
| | - Elisabeth Polard
- Regional Pharmacovigilance Center, Rennes University Medical Center, Rennes, France
| | - Sylvie Picard
- Regional Pharmacovigilance Center, Rennes University Medical Center, Rennes, France
| | - Sandrine Bergeron
- Regional Pharmacovigilance Center, Lille University Medical Center, Lille, France
| | - Paola Sanchez-Pena
- Regional Pharmacovigilance Center, Bordeaux University Medical Center, Bordeaux, France
| | - Alain Dupuy
- Dermatology Department, Rennes University Medical Center, Rennes, France; Univ Rennes, INSERM, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
| | - Louise Triquet
- Regional Pharmacovigilance Center, Rennes University Medical Center, Rennes, France
| | - Catherine Droitcourt
- Dermatology Department, Rennes University Medical Center, Rennes, France; Univ Rennes, INSERM, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France.
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Jia QN, Qiao J, Fang K, Zeng YP. Ocular Adverse Effects in Atopic Dermatitis Patients Treated With Dupilumab: A Bibliometric Analysis. Front Med (Lausanne) 2022; 9:802036. [PMID: 35308529 PMCID: PMC8927737 DOI: 10.3389/fmed.2022.802036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/31/2022] [Indexed: 11/18/2022] Open
Abstract
Background Atopic dermatitis (AD) is one of the most common chronic inflammatory skin disorders. Dupilumab, the first targeted biological drug approved for the treatment of AD, has been widely used, along with increasing ocular adverse effects (AEs). Objective To perform a bibliometric analysis of all the qualified literature involving ocular AEs during the treatment of AD with dupilumab. Methods Relevant studies were extracted from the Web of Science database and screened by researchers. The bibliographic analysis was performed using the VOSviewer. Results A total of 138 articles were enrolled in this study. The first study was published in 2016 by Oregon Health and Science University from the United States. The majority of publications were published in the past 3 years. British Journal of Dermatology published the highest number of articles. The United States was the country with the most publications. Sanofi (France) and Regeneron Pharmaceuticals (USA) were the leading organizations with the most contributions. Conjunctivitis was the most common ocular AE. The management of AD will continue to be the research hotspot and development trend in this area. The milestone research is the first article “Two Phase 3 Trials of Dupilumab vs. Placebo in Atopic Dermatitis” published in the New England Journal of Medicine. Most of the top 10 papers were mainly randomized, placebo-controlled phase 2 and phase 3 clinical trials and real-life large cohort studies. Conclusions This study may help better understand ocular AEs in the dupilumab treatment of AD, and grasp the research trends and most influential topics in this field.
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Mastorino L, Ortoncelli M, Virginia B, Rolla G, Avallone G, Cavaliere G, Riccardo V, Quaglino P, Ribero S. Dupilumab-induced Urticaria. Dermatol Ther 2021; 34:e15117. [PMID: 34459079 DOI: 10.1111/dth.15117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/24/2021] [Accepted: 08/27/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Luca Mastorino
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Michela Ortoncelli
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Bernardi Virginia
- Allergy and Clinical Immunology Unit, Department of Medical Sciences, University of Turin and Mauriziano Hospital, Turin, Italy
| | - Giovanni Rolla
- Allergy and Clinical Immunology Unit, Department of Medical Sciences, University of Turin and Mauriziano Hospital, Turin, Italy
| | - Gianluca Avallone
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Giovanni Cavaliere
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Viola Riccardo
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Pietro Quaglino
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Simone Ribero
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
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Francuzik W, Alexiou A, Worm M. Safety of dupilumab in patients with atopic dermatitis: expert opinion. Expert Opin Drug Saf 2021; 20:997-1004. [PMID: 34114910 DOI: 10.1080/14740338.2021.1939673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Introduction: Dupilumab, the first biologic drug to be approved for the treatment of moderate to severe atopic dermatitis in adolescents and adults, has shown efficacy and safety in clinical trials. Data on long-term safety is limited but crucial for pharmacovigilance. Therefore, we performed this review to evaluate available real-world data on the long-term safety of dupilumab in atopic dermatitis.Areas covered: PubMed and Google Scholar databases were searched for randomized controlled clinical trials (RCTs), observational studies, case series, and case reports regarding the use of dupilumab for the treatment of atopic dermatitis. Adverse events were summarized and critically evaluated.Expert opinion: Atopic dermatitis patients receiving dupilumab reported ocular surface disease more often than patients receiving placebo. Real-world data show previously unreported adverse events (blood eosinophilia, rosacea-like skin lesions, weight gain), but their mechanistic association to dupilumab treatment still requires clarification. Cutaneous T-cell lymphomas occurring under the therapy with dupilumab might be unrelated to the drug use itself but long-term follow-up data of large patient cohorts is necessary to rule out such possibility. Real-world data show that dupilumab is well tolerated in atopic dermatitis; however, ocular adverse events are not rare. Registries are needed to monitor future adverse events.
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Affiliation(s)
- Wojciech Francuzik
- Div. Allergy and Immunology, Department of Dermatology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Aikaterina Alexiou
- Div. Allergy and Immunology, Department of Dermatology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Margitta Worm
- Div. Allergy and Immunology, Department of Dermatology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
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7
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Treudler R, Delaroque N, Puder M, Simon JC, Szardenings M. Dupilumab-induced serum sickness-like reaction: an unusual adverse effect in a patient with atopic eczema. J Eur Acad Dermatol Venereol 2020; 35:e30-e32. [PMID: 32594596 DOI: 10.1111/jdv.16782] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- R Treudler
- Department of Dermatology, Venereology and Allergology, Leipzig Interdisciplinary Allergy Centre - LICA, Universität Leipzig, Leipzig, Germany
| | - N Delaroque
- Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany
| | - M Puder
- epitopic GmbH, Leipzig, Germany
| | - J-C Simon
- Department of Dermatology, Venereology and Allergology, Leipzig Interdisciplinary Allergy Centre - LICA, Universität Leipzig, Leipzig, Germany
| | - M Szardenings
- Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany.,epitopic GmbH, Leipzig, Germany
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