Case Study: Patient With Severe AD, Type 2 Inflammatory Comorbidities Rapidly Improves With Dupilumab

A 43-year-old woman with severe atopic dermatitis and multiple type 2 inflammatory comorbidities experienced rapid improvement of symptoms with dupilumab treatment, according to a case report published online in Clinical and Molecular Allergy.

“[W]e suggest that patients suffering from atopic dermatitis, asthma, allergic rhinitis, and chronic rhinosinusitis with nasal polyps may be eligible for dupilumab single treatment that is possibly advantageous also from the pharmaco-economic standpoint,” wrote researchers from the University of Bari Aldo Moro and “F. Miulli” Hospital in Italy.

According to the case report, the patient had atopic dermatitis since infancy and a long-standing history of a mild, perennial allergic rhino-conjunctivitis, moderate asthma, and chronic rhinosinusitis with nasal polyps. In addition to taking a variety of medications, she underwent surgical excision of bilateral nasal polyps a decade earlier. At presentation, her daily medication regimen included potent topical steroids and desloratadine, and combination therapy consisting of inhaled beclometasone and formoterol fumarate twice daily.

Within 16 weeks of beginning dupilumab, the woman showed improvement on a slate of atopic dermatitis and type 2 comorbidity assessments, including a decrease from 29 to 4 points on the Eczema Area and Severity Index, a drop from 78 to 16 points on the SCORing Atopic Dermatitis scale, and a reduction from 4 to 2 points on the Investigator's Global Assessment score.

Over the 16-week treatment period, the patient was able to discontinue topical corticosteroids as well as reduce her use of antihistamines and asthma combination therapy. She reported no side effects with dupilumab, according to the article.

“To our knowledge,” researchers wrote, “this case is the first report describing rapid, successful treatment of severe atopic dermatitis and comorbid type 2 inflammatory diseases in the same patient, with dupilumab treatment, with no side-effects.”

Reference:
Nettis E, Masciopinto L, Di Leo E, et al. Dupilumab elicits a favorable response in type-2 inflammatory comorbidities of severe atopic dermatitis. Clin Mol Allergy. 2021;19(1):9. Published 2021 Jun 16. doi:10.1186/s12948-021-00144-x