Safety of dupilumab in severe atopic dermatitis and infection of Covid‐19: two case reports

Ferrucci, Silvia; Romagnuolo, Maurizio; Angileri, Luisa; Berti, Emilio; Tavecchio, Simona

doi:10.1111/jdv.16527

Cited by 54 publications

(49 citation statements)

References 12 publications

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“…We also observed lower plasma levels of the macrophage activation marker sCD163, although macrophages infiltrating the lungs of COVID-19 patients expressed may also be counteracted with monoclonal antibodies. For instance, dupilumab, a monoclonal antibody against IL-4, has been safely used in patients with atopic dermatitis and COVID-19, without increased risk of severe complications of the infection, and even some patients receiving dupilumab that later acquired the infection with SARS-CoV-2 did not show respiratory symptoms (64)(65)(66). Finally, TSLP could be another target to inhibit Th2 responses in COVID-19 patients, as this molecule promotes allergic inflammation (36), and indeed, high levels of TSLP were observed in our cohort of COVID-19 but not influenza subjects.…”

Section: Discussionmentioning

confidence: 99%

Clinical and immunological factors that distinguish COVID-19 from pandemic influenza A(H1N1)

Choreño-Parra

Jiménez-Álvarez

Cruz‐Lagunas

et al. 2020

Preprint

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), is a global health threat with the potential to cause severe disease manifestations in the lungs. Although clinical descriptions of COVID-19 are currently available, the factors distinguishing SARS-CoV-2 from other respiratory viruses are unknown. Here, we compared the clinical, histopathological, and immunological characteristics of patients with COVID-19 and pandemic influenza A(H1N1). We observed a higher frequency of respiratory symptoms, increased tissue injury markers, a histological pattern of alveolar pneumonia, and higher levels of IL-1RA, TNF-α, CCL3, G-CSF, APRIL, sTNF-R1, sTNF-R2, sCD30, and sCD163 in influenza patients. Conversely, dry cough, gastrointestinal symptoms, interstitial lung pathology, increased Th1 (IL-12, IFN-γ) and Th2 (IL-4, IL-5, IL-10, IL-13) cytokine levels, along with IL-1β, IL-6, CCL11, VEGF, TWEAK, TSLP, MMP-1, and MMP-3, were observed in COVID-19 cases. We demonstrated the diagnostic potential of some clinical and immune factors to differentiate COVID-19 from pandemic influenza A(H1N1). Our data suggest that SARS-CoV-2 induces a dysbalanced polyfunctional inflammatory response that is different from the immune response against influenza. These findings might be relevant for the upcoming 2020-2021 influenza season, which is projected to be historically unique due to its convergence with COVID-19.

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Section: Discussionmentioning

confidence: 99%

Clinical and immunological factors that distinguish COVID-19 from pandemic influenza A(H1N1)

Choreño-Parra

Jiménez-Álvarez

Cruz‐Lagunas

et al. 2020

Preprint

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“…However, recently, dupilumab was proposed as an agent that could be beneficial in severe ARDS by alleviating cytokine storm 17 . A recent report from Italy described two patients with AD who continued dupilumab treatment during COVID-19 and successfully recovered from the infection 18 . Another group from Italy recommended continuing dupilumab during COVID-19 pandemic based on the observations of elevation of Th2 cytokines in COVID-19 and fatal cases of SARS-CoV and the effect of IL-6 on polarizing Th1/ Th2 balance to the Th2 direction 19 .…”

Section: Strategies For Coping With Stress To Prevent Disease Exacerbmentioning

confidence: 99%

Recommendations on the use of systemic treatments for urticaria and atopic dermatitis during the COVID-19 pandemic: Statement of Dermatoallergy Working Group of the Turkish Society of Dermatology

Salman¹,

Alper²,

Atakan³

et al. 2020

TURKDERM

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“…Zu beachten sind mögliche metabolische Interaktionen zwischen CyA und Lopinavir/Ritonavir (CYP3-Inhibitoren). Berichtet wurde über zwei Patienten mit AD, bei denen es unter der Therapie mit Dupilumab nicht zu einem schwereren Verlauf von Covid-19 kam [64].…”

Section: Typ-2-blockade Bei Sars-cov-2unclassified

Anwendung von Biologika bei allergischen und Typ-2-entzündlichen Erkrankungen in der aktuellen Covid-19-Pandemiea, b, c

Klimek¹,

Pfaar²,

Worm³

et al. 2020

Allergo J

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a Überarbeitete, aktualisierte und inhaltlich auf die Situation in Deutschland, Österreich, der Schweiz und Luxemburg adaptierte Fassung des EAACI-Positionspapiers: Vultaggio et al. Considerations on Biologicals for Patients with allergic disease in times of the COVID-2 19 pandemic: an EAACI Statement. Allergy (submitted). b Die ersten fünf Autoren sind gemeinsame Erstautoren. c Die letzten vier Autoren sind gemeinsame Letztautoren.

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Safety of dupilumab in severe atopic dermatitis and infection of Covid‐19: two case reports

Abstract: 5 Joly P, Maho-Vaillant M, Prost-Squarcioni C et al. First-line rituximab combined with short-term prednisone versus prednisone alone for the treatment of pemphigus (Ritux 3): a prospective, multicentre, parallelgroup, open-label randomised trial.

Cited by 54 publications

References 12 publications

Clinical and immunological factors that distinguish COVID-19 from pandemic influenza A(H1N1)

Clinical and immunological factors that distinguish COVID-19 from pandemic influenza A(H1N1)

Recommendations on the use of systemic treatments for urticaria and atopic dermatitis during the COVID-19 pandemic: Statement of Dermatoallergy Working Group of the Turkish Society of Dermatology

Anwendung von Biologika bei allergischen und Typ-2-entzündlichen Erkrankungen in der aktuellen Covid-19-Pandemiea, b, c

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