An Uncommon Case of Dulaglutide-Related Morbilliform Drug Eruption

Abstract

Dulaglutide is a once-weekly injectable glucagon-like peptide-1 (GLP-1) receptor agonist that has shown a durable glycemic efficacy as well as beneficial effects on body weight and major adverse cardiovascular events (MACE) outcomes, making it an important option for the treatment of type 2 diabetes. Common side effects of dulaglutide include nausea, diarrhea, and abdominal distension, and these are usually mild to moderate in severity and tend to diminish over time. Morbilliform drug eruptions to dulaglutide are very rare, with only one case reported until now. We report another case of dulaglutide-morbilliform drug eruption to alert the attending physicians that dulaglutide-related adverse skin reactions should be kept in mind as generalized use of dulaglutide and other GLP-1 receptor agonists are expected to remain in widespread clinical use in the future.

Hypersensitivity to glucagon‐like peptide‐1 receptor agonists: A case of delayed urticaria‐like rash to dulaglutide and literature review

“…Patch test (PT) and skin prick test (SPT) with undiluted drug and intradermal test (IDT) with progressively decreasing dilutions (1:1000, 1:100, 1:10 in saline solution and as is, 0.04 mL) were performed. Since skin tests with this drug were not performed in the other five published cases of suspected dulaglutide allergic reactions, [3][4][5][6][7] the aforementioned concentrations for dulaglutide skin testing were chosen according to literature data on cases of hypersensitivity drug reaction to other GLP1RAs. [8][9][10][11][12][13] Skin test readings were performed at 20 min, day (D)2 and D3 for PT, at 20 min and D1 for SPT and at 20 min and D1 for IDT.…”

“…According to the Food and Drug Administration, dulaglutide can reduce major adverse cardiovascular events (MACEs) in adults with T2DM and with cardiovascular (CV) disease or with multiple CV risk factors. 2 The most frequently adverse drug reactions (ADRs) reported involve the gastrointestinal tract, but it rarely can be responsible for cutaneous eruptions, 3,4 angioedema and anaphylaxis. [5][6][7]…”