A Review of Dupilumab-Induced Adverse Events to Dermatologists and the Potential Pathogenesis in the Treatment of Atopic Dermatitis.

IF 4 3区 医学 Q1 DERMATOLOGY Dermatitis Pub Date : 2024-01-01 Epub Date: 2023-05-19 DOI:10.1089/derm.2022.0096
Jun-Hong Tsai, Tsen-Fang Tsai
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Abstract

Dupilumab, a monoclonal antibody targeting interleukin-4 antibody, is approved for use in many type 2 inflammatory diseases, including atopic dermatitis. It is generally well tolerated with no need of routine laboratory monitoring. However, several adverse events have been reported during real-world practice and in pivotal trials. We conducted a systematic literature research of the PubMed, Medline, and Embase databases to identify articles recording the clinical manifestation and potential pathogenesis of these adverse events with interests (AEIs) to dermatologists. In total, 547 cases from 134 studies have developed 39 AEIs 1 day to 2.5 years after dupilumab treatment. The most common AEIs are facial and neck dermatitis (299 cases), psoriasis (70 cases), arthralgia (56 cases), alopecia (21 cases), cutaneous T cell lymphoma (19 cases), severe ocular diseases (19 cases), and drug eruption (6 cases). Most of the AEIs recorded in this review resolved or improved after dupilumab discontinuation or the addition of another treatment, whereas 3 of the cases died of severe AEI. The potential pathogenesis included T help type 1 (Th1)/T help type 2 (Th2) imbalance, Th2/T help type 17 (Th17) imbalance, immune reconstitution, hypersensitivity reaction, transient hypereosinophilia related, and Th1 suppression. Clinicians should be alert of these AEIs for timely diagnosis and appropriate treatment.

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回顾杜匹单抗在治疗特应性皮炎过程中给皮肤科医生带来的不良反应以及潜在的发病机制。
杜匹鲁单抗是一种靶向白细胞介素-4抗体的单克隆抗体,已被批准用于包括特应性皮炎在内的多种2型炎症性疾病。该药的耐受性一般良好,无需进行常规实验室监测。然而,在实际应用和关键试验中也有一些不良事件的报道。我们对 PubMed、Medline 和 Embase 数据库进行了系统的文献研究,以找出记录这些不良事件(AEIs)的临床表现和潜在致病机理的文章,供皮肤科医生参考。共有来自 134 项研究的 547 个病例在杜匹单抗治疗后 1 天至 2.5 年内发生了 39 例 AEI。最常见的 AEI 包括面部和颈部皮炎(299 例)、银屑病(70 例)、关节痛(56 例)、脱发(21 例)、皮肤 T 细胞淋巴瘤(19 例)、严重眼部疾病(19 例)和药物疹(6 例)。本综述中记录的大多数 AEI 在停用杜匹单抗或增加另一种治疗方法后缓解或改善,而其中 3 例因严重 AEI 而死亡。潜在的发病机制包括T帮助1型(Th1)/T帮助2型(Th2)失衡、Th2/T帮助17型(Th17)失衡、免疫重建、超敏反应、一过性嗜酸性粒细胞过多相关和Th1抑制。临床医生应警惕这些 AEI,以便及时诊断和采取适当的治疗措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Dermatitis
Dermatitis 医学-皮肤病学
CiteScore
5.30
自引率
11.50%
发文量
251
审稿时长
>12 weeks
期刊介绍: Dermatitis is owned by the American Contact Dermatitis Society and is the home journal of 4 other organizations, namely Societa Italiana di Dermatologica Allergologica Professionale e Ambientale, Experimental Contact Dermatitis Research Group, International Contact Dermatitis Research Group, and North American Contact Dermatitis Group. Dermatitis focuses on contact, atopic, occupational, and drug dermatitis, and welcomes manuscript submissions in these fields, with emphasis on reviews, studies, reports, and letters. Annual sections include Contact Allergen of the Year and Contact Allergen Alternatives, for which papers are chosen or invited by the respective section editor. Other sections unique to the journal are Pearls & Zebras, Product Allergen Watch, and news, features, or meeting abstracts from participating organizations.
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