Dupilumab Eases Type 2 Inflammation in Atopic Dermatitis, Allergic Diseases

In patients with atopic dermatitis, asthma, chronic rhinosinusitis with nasal polyps (CRSwNP), and eosinophilic esophagitis, dupilumab decreased levels of type 2 inflammatory biomarkers, according to study results published online ahead of print in Clinical & Experimental Allergy. 

“Type 2 inflammation is common in numerous atopic/allergic diseases and can be identified by elevated biomarker levels,” researchers explained in the study background. “Dupilumab, a fully human monoclonal antibody, blocks the shared receptor component for interleukin-4 and interleukin-13, key and central drivers of type 2 inflammation.” 

The study was based on extracted data from three randomized placebo-controlled trials of dupilumab in patients with atopic dermatitis, one randomized placebo-controlled trial of dupilumab in patients with asthma, one such study involving patients with CRSwNP, and another of patients with eosinophilic esophagitis. 

Compared with placebo, dupilumab significantly suppressed most type 2 inflammatory biomarker levels across all studies and indications, according to the findings. 

“Reductions in serum thymus and activation-regulated chemokine (TARC), plasma eotaxin-3, and serum periostin occurred rapidly,” researchers reported, “whereas reductions in serum total immunoglobulin E (IgE) were more gradual.” 

Across diseases, median percentage change from baseline to end of treatment ranged from -24.8% to -88.6% for TARC levels; -38.2% to -51.5% for eotaxin-3; -24.8% to -76.7% for total IgE; and -13.6% to -41.1% for serum periostin levels, according to the study.  

Changes to blood eosinophil count differed with disease. The median percentage change from baseline to end of treatment was 0% in patients with atopic dermatitis, the study found. For patients with asthma and CRSwNP, researchers observed transient increases, followed by decreases, to below-baseline levels. Patients with eosinophilic esophagitis, meanwhile, showed significant decreases in blood eosinophil count with dupilumab.  

—Jolynn Tumolo

Reference:

Hamilton JD, Harel S, Swanson BN, et al. Dupilumab suppresses type 2 inflammatory biomarkers across multiple atopic, allergic diseases [published online ahead of print, 2021 May 26]. Clin Exp Allergy. 2021;10.1111/cea.13954. doi:10.1111/cea.13954