Dupilumab has a profound effect on <scp>specific‐IgE</scp> levels of several food allergens in atopic dermatitis patients

Spekhorst, Lotte S; Rijst, Lisa P. van de; Graaf, Marlies de; Megen, Maxime van; Zuithoff, Nicolaas P. A.; Knulst, André C.; Bruin‐Weller, Marjolein de; Le, Thuy‐My

doi:10.1111/all.15591

Cited by 35 publications

(27 citation statements)

References 6 publications

(8 reference statements)

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“…While dupilumab might affect additional aspects of atopic disease, 168–170 dupilumab leads to a 20%–50% drop in serum IgE over several months, 166,171–174 and >80% loss over treatment periods of 1 year or more 175–178 in allergic asthma, allergic rhinitis with or without nasal polyps, and atopic dermatitis patients, which fits with the notion that most IgE + ASC are short‐lived cells in these diseases. Dupilumab also diminishes peanut‐specific IgE titres >90% over a 3‐year timecourse 178 . Two studies suggest limited antigen‐specific IgE titer change in pollen allergic individuals over a four‐month period with dupilumab alone, which would instead indicate persistent IgE + ASC cause pollen allergy 179,180 .…”

Section: The Life Spans Of Ige+ Ascsupporting

confidence: 80%

The origins and longevity of IgE responses as indicated by serological and cellular studies in mice and humans

Ding

Mulder

Robinson

2023

Allergy

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The existence of long‐lived IgE antibody‐secreting cells (ASC) is contentious, with the maintenance of sensitization by the continuous differentiation of short‐lived IgE+ ASC a possibility. Here, we review the epidemiological profile of IgE production, and give an overview of recent discoveries made on the mechanisms regulating IgE production from mouse models. Together, these data suggest that for most individuals, in most IgE‐associated diseases, IgE+ ASC are largely short‐lived cells. A subpopulation of IgE+ ASC in humans is likely to survive for tens of months, although due to autonomous IgE B cell receptor (BCR) signaling and antigen‐driven IgE+ ASC apoptosis, in general IgE+ ASC probably do not persist for the decades that other ASC are inferred to do. We also report on recently identified memory B cell transcriptional subtypes that are the likely source of IgE in ongoing responses, highlighting the probable importance of IL‐4Rα in their regulation. We suggest the field should look at dupilumab and other drugs that prohibit IgE+ ASC production as being effective treatments for IgE‐mediated aspects of disease in most individuals.

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Section: The Life Spans Of Ige+ Ascsupporting

confidence: 80%

The origins and longevity of IgE responses as indicated by serological and cellular studies in mice and humans

Ding

Mulder

Robinson

2023

Allergy

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“…In 2022, a study demonstrated that Dupilumab could decrease the patient's IgE levels, inhibiting the Th2 immune response. Participants received Dupilumab for 52 weeks, and the total IgE and specific IgE levels decreased more than 80% [29,30]. The study echoed results of previous trials [31].…”

Section: Therapies Targeting Interleukin-4 and Interleukin-13supporting

confidence: 70%

Biologicals in IgE-mediated food allergy

Mutarelli

Giavina-Bianchi

Arasi

et al. 2023

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of reviewA better understanding of the most recent scientific literature in the use of biological therapy in the treatment of patients with IgE-mediated food allergy. Recent findingsA systematic review and meta-analysis demonstrated safety and effectiveness of omalizumab in the treatment of food allergy. The findings support the potential use of omalizumab as a monotherapy or as an adjunct to oral immunotherapy in IgE-mediated cow's milk allergy. The potential use of other biologics in the management of food allergy is subject of speculation. SummaryDifferent biological therapies are under evaluation for food allergic patients. The advance in literature will guide for a personalized treatment in the near future. However, additional research is needed to better understand the best candidate for each treatment, the optimal dose and timing.

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“…Dupilumab was proven to be an efficacious inhibitor of type II inflammation by blocking IL-4Ra, thus, it could alleviate the symptoms of AD, allergic rhinitis, and asthma at the same time (31). A recent study also endorsed that the dupilumab provided a possible additional advantage for AD patients with concomitant food allergy (32). Additionally, whether early intervention of dupilumab could block the progress of atopic march is also an exciting issue and need more research to confirm.…”

Section: B Amentioning

confidence: 99%

High loading-dose of dupilumab resulted in rapid disease control in pediatric patients with atopic dermatitis

et al. 2023

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BackgroundThe real-world experience of dupilumab in Chinese is limited, and the initial loading dose has not yet been deeply explored in patients aged <6 years.ObjectiveTo explore the efficacy and safety of dupilumab in Chinese patients with moderate-to-severe atopic dermatitis and investigate the effect of higher loading dose for disease control in patients aged <6 years.MethodsA total of 155 patients were divided into three groups according to age: <6 years, 6-11 years, and >11 years. Among patients aged <6 years, 37 patients received a high loading dose of 300 mg for body weight <15kg or 600 mg for body weight ≥15kg, and another 37 patients received a standard loading dose of 200 mg for body weight <15kg or 300 mg for body weight ≥15kg. Multiple physicians and patient-reported outcome measures were evaluated at baseline and 2, 4, 6, 8, 12, and 16 weeks after dupilumab treatment.ResultsThe proportion of patients showing an improvement of ≥75% in the Eczema Area and Severity Index was 68.0% (17/25), 76.9% (10/13), and 62.5% (25/40) in the aged <6, 6-11, and >11 years groups, respectively, at week 16. After increasing the loading dose, 69.6% (16/23) of patients aged <6 years achieved 4-point improvement in Pruritus Numerical Rating Scale at week 2, compared with 23.5% (8/34) of patients receiving standard loading dose (P < 0.001). Obesity (odds ratio=0.12, 95% confidence interval: 0.02-0.70) was predictive of a poor response to dupilumab treatment, while female (odds ratio=3.94, 95% confidence interval: 1.26-12.31) predicted good response at week 16. The change of serum C-C motif ligand 17(CCL17/TARC) could reflect the response to dupilumab (r = 0.53, P = 0.002 in EASI) among patients aged <18 years. No major adverse events were reported during the treatment.ConclusionsDupilumab was effective and well-tolerated in Chinese patients with atopic dermatitis. The increased loading dose helped achieve rapid pruritus control in patients aged <6 years.

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Dupilumab has a profound effect on specific‐IgE levels of several food allergens in atopic dermatitis patients

Cited by 35 publications

References 6 publications

The origins and longevity of IgE responses as indicated by serological and cellular studies in mice and humans

The origins and longevity of IgE responses as indicated by serological and cellular studies in mice and humans

Biologicals in IgE-mediated food allergy

High loading-dose of dupilumab resulted in rapid disease control in pediatric patients with atopic dermatitis

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