Polyenthesitis during treatment with dupilumab for atopic dermatitis

Arthritis and enthesitis during dupilumab therapy completely remitted by celecoxib

“…This result indicates that dupilumab can impair the protective role for IL-4/IL-13 in Th17-associated enthesitis. Consistently, in our case and a previous five cases who were examined by ultrasound, 1,3,4 features of enthesitis were detected. Among the five cases whose courses after diagnosis were reported, three stopped dupilumab therapy and two continued the therapy with additional oral celecoxib like our case.…”

“…There have been six reported cases with arthritis or enthesitis whose onset was within 16 weeks after initiation of dupilumab therapy for AD (Table S1). [1][2][3][4] Bridegwood et al 4 found that IL-4/IL-13 suppressed IL-23 expression from digested enthesis tissue treated with lipopolysaccharide. This result indicates that dupilumab can impair the protective role for IL-4/IL-13 in Th17-associated enthesitis.…”

Dupilumab‐induced psoriatic erythroderma with characteristic cytokine and antimicrobial peptide expression pattern in a patient with long standing atopic dermatitis

“…In line with previous reports, 1–6 we hypothesize that inhibiting the Th‐2 response with an IL‐4/IL‐13 signaling pathway blocking agent might result in a shift toward a Th‐1/Th‐17 phenotype. In predisposed patients, such a cytokine shift could then lead to an inflammatory cascade finally resulting in realization of psoriatic lesions.…”

Pathophysiology of psoriasis: A review

“…77 The development of arthralgia and enthesitis, a characteristic feature of psoriatic arthritis, has also been reported after the use of dupilumab. 78 Furthermore, the administration of dupilumab worsens skin lesions in psoriasis. 79 It has also been reported that the administration of IL-4 improved psoriasis symptoms.…”