Dupilumab en Penfigoide ampolloso

Published in Dermatology

Journal Scan / Research · March 30, 2020

Dupilumab as a Novel Therapy for Bullous Pemphigoid

Journal of the American Academy of Dermatology

TAKE-HOME MESSAGE

• In this series, 13 patients with refractory bullous pemphigoid were treated with dupilumab. Of the total, 7 patients achieved disease clearance and 5 had documented clinical improvement. Of the patients who achieved disease clearance, 3 required more frequent dupilumab dosing, as much as 300 mg subcutaneously every week. Median response time of responders was 2 months.

• This case series suggests that dupilumab may be an effective therapy in refractory bullous pemphigoid, possibly because of the role of IL-4 and IL-13 in the pathogenesis of this disease. Further controlled studies are needed to validate these observations.

– Margaret Hammond, MD

Abstract

IMPORTANCE

Bullous pemphigoid is an autoimmune blistering disorder occurring mostly in the elderly that lacks adequate treatments

OBJECTIVE

To describe our experience using dupilumab in a series of patients with bullous pemphigoid

METHODS

This is a case series of patients from five academic centers receiving dupilumab for bullous pemphigoid Patients were eligible if they had a clinical diagnosis of BP confirmed by lesional skin biopsy evaluated by hematoxylin-eosin staining, and/or direct immunofluorescence (DIF) and/or enzyme linked immunosorbent assay (ELISA) for BP180 and/or BP230. .

RESULTS

We identified 13 patients. The average age of the patients was 76.8 and the average duration of bullous pemphigoid prior to dupilumab initiation was 28.8 months (range 1 to 60 months). 92.3% (12/13) of patients achieved either disease clearance or satisfactory response. Satisfactory response was defined as clinician documentation of disease improvement and patient desire to stay on the medication without documentation of disease clearance. 53.8% (7/13) of patients achieved total clearance of their bullous pemphigoid. No adverse events were reported.

LIMITATIONS

Include small sample size, lack of a control group, lack of a standardized assessment tool, and lack of standardized safety monitoring.

CONCLUSIONS

Dupilumab may be an additional treatment for BP, leading to disease clearance or satisfactory response in 92.3% of patients including in those who previously failed conventional therapy.

Journal of the American Academy of Dermatology

Dupilumab as a Novel Therapy for Bullous Pemphigoid: A Multicenter Case Series

J Am Acad Dermatol 2020 Mar 13;[EPub Ahead of Print], R Abdat, RA Waldman, V de Bedout, A Czernik, M Mcleod, B King, S Gordon, R Ahmed, A Nichols, M Rothe, D Rosmarin 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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