Dupilumab: A Review of Present Indications and Off-Label Uses

Abstract

Recent advances in understanding T2 inflammation have broadened the diseases in which T2 inflammation can be involved. Dupilumab is a recently developed monoclonal antibody blocking the signaling of both IL-4 and IL13, two crucial cytokines of the T2 responses. New possible indications are increasingly exploring. Among them are skin diseases, such as prurigo nodularis, nummular eczema, allergic contact dermatitis, chronic hand eczema, spontaneous chronic urticaria, bullous pemphigoid, alopecia areata, and Netherton syndrome, among other several cutaneous diseases. Also, respiratory diseases, such as allergic bronchopulmonary aspergillosis, chronic eosinophilic pneumonia, and allergic rhinitis. In addition, eosinophilic gastrointestinal disorders, particularly eosinophilic esophagitis, and food allergy are two more research fields. Here we review the published data and clinical trials about the use of dupilumab in these disorders.

Síndrome de Netherton: diagnóstico, formas de tratamento e o papel do cuidado farmacêutico em prol da saúde nesta patologia

“…(Giavina-Bianchi, et al, 2018). Essa terapia vem se mostrando bastante eficaz em pacientes com dermatite atópica (DA) e também em pacientes com condições dermatológicas crônicas off-label, mas ainda é necessário a realização de mais estudos confirmatórios para o uso deste medicamento (Muñoz-Bellido, et al, 2021).…”

Simultaneous treatment of Samter triad and prurigo nodularis with dupilumab

“…Off-label use of dupilumab is found to be effective for various other atopic and dermatologic conditions, including bullous pemphigoid and PN. 5 There is only 1 other report describing the use of dupilumab for the treatment of ST. Ten patients were treated for 6 months and showed improvement in both SNOT and asthma measures.…”

“…4 Dupilumab is approved by the Food and Drug Administration for the treatment of moderateto-severe atopic dermatitis (AD), CRSwNP, and asthma; however, it is not approved for ST or PN. 5 The shared role of Th2-related cytokines in the pathogenesis of both ST and PN suggests that dupilumab may be an effective treatment for both conditions as underscored by recent publications. 5,6 Here, we report the simultaneous improvement of ST and PN in a patient treated with dupilumab.…”

“…5 The shared role of Th2-related cytokines in the pathogenesis of both ST and PN suggests that dupilumab may be an effective treatment for both conditions as underscored by recent publications. 5,6 Here, we report the simultaneous improvement of ST and PN in a patient treated with dupilumab.…”

Insights into the Implications of Coexisting Type 2 Inflammatory Diseases

“…56 A recent Phase 2 clinical trial has also shown promise in the management of EOE, 14 results that other biologic agents have failed to produce up to this point. 57 So, while it is clear that we have made great strides over the past few decades in the treatment of Th2 mediated diseases, questions still remain and further research must be conducted to better understand the epidemiological variability across these disease states.…”