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Dupilumab: A Review in Moderate-to-Severe Atopic Dermatitis

  • Adis Drug Evaluation
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Abstract

Dupilumab (Dupixent®), a subcutaneously administered, fully human IgG4 monoclonal antibody directed against the IL (interleukin)-4 receptor α subunit, blocks the signalling of IL-4 and IL-13, two T helper cell type 2 cytokines implicated in the immunopathology of atopic dermatitis (AD). It is the first biologic therapy to have been approved for the treatment of adult patients with moderate-to-severe AD in the EU and USA. In phase III trials in adults with moderate-to-severe AD who were inadequately controlled with topical medications and/or systemic treatments, such as ciclosporin, or for whom these therapies were not advisable, 16 weeks’ treatment with dupilumab as monotherapy or in combination with topical corticosteroids (TCS) improved multiple measures of disease severity, pruritus, sleep disturbance, anxiety and depression, and quality of life compared with placebo. Moreover, the benefits of combination therapy at week 16 were maintained during long-term treatment for up to 1 year. Dupilumab, alone or added to TCS, was generally well tolerated, with low rates of serious adverse events and treatment discontinuations due to adverse events. Common adverse reactions included conjunctivitis, injection-site reactions and oral herpes. Thus, dupilumab represents a valuable new treatment option for adults with moderate-to-severe AD deemed appropriate for systemic therapy, a patient population for whom historically there has been a lack of safe and effective long-term treatments.

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Acknowledgements

During the peer review process, the manufacturer of dupilumab was also offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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  1. Springer, Private Bag 65901, Mairangi Bay, Auckland, 0754, New Zealand

    James E. Frampton & Hannah A. Blair

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  1. James E. Frampton
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Correspondence to James E. Frampton.

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The preparation of this review was not supported by any external funding.

Conflict of interest

James Frampton and Hannah Blair are salaried employees of Adis/Springer, are responsible for the article content and declare no relevant conflicts of interest.

Additional information

The manuscript was reviewed by: M Gooderham, Department of Medicine, Queen’s University, Kingston, ON, Canada; M. Megna, Department of Dermatology, University of Naples Federico II, Naples, Italy.

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Frampton, J.E., Blair, H.A. Dupilumab: A Review in Moderate-to-Severe Atopic Dermatitis. Am J Clin Dermatol 19, 617–624 (2018). https://doi.org/10.1007/s40257-018-0370-9

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