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Do Clinical Symptoms Improve With Dupilumab in Bullous Pemphigoid?

Rapid and sustained improvement in clinical indicators and laboratory examination results seen after treatment

By Dermsquared Editorial Team | August 02, 2023

WEDNESDAY, Aug. 2, 2023  -- For patients with bullous pemphigoid (BP), dupilumab is associated with improved clinical symptoms, according to a study published online Aug. 2 in JAMA Dermatology.

Liuqi Zhao, M.D., from Peking University First Hospital in China, and colleagues examined the efficacy and safety of dupilumab in patients with BP in a retrospective cohort study. A total of 146 adult patients with a clinical presentation of BP combined with immunological or pathological evidence, who received 300 mg of dupilumab every two weeks following an initial dose of 600 mg, were included in the study.

The researchers found that 87.0 percent of the patients achieved disease control within four weeks (median time, 14 days). Overall, 35.6 and 8.9 percent of patients achieved complete remission and relapsed during the observation period, respectively. At week 64, the complete remission rate and cumulative relapse rate were 62.5 and 30.9 percent, respectively. After dupilumab treatment, rapid and sustained improvement in clinical indicators and laboratory examination results were seen, including Bullous Pemphigoid Disease Area Index scores, itching numerical rating scale scores, serum anti-BP180 and anti-BP230 antibodies, total immunoglobulin E levels, and eosinophil count. Overall, 73.3 percent of the patients did not report any adverse events. Infections and eosinophilia were the most common adverse events. Serum anti-BP180 antibody levels >50 relative units/mL were associated with four-week disease control (odds ratio, 3.63; 95 percent confidence level, 0.97 to 12.61; P = 0.045), while relapse was more likely among male patients (hazard ratio, 10.97; 95 percent confidence level, 1.42 to 84.92; P = 0.02).

"We found that dupilumab effectively alleviated clinical and serological indicators of patients with BP," the authors write. "The safety profile was favorable, while the risk of infection and eosinophilia were notable concerns."


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