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No Evidence That Live Vaccines Are Unsafe for Patients on Dupilumab

Systematic review shows vaccine efficacy not affected by dupilumab in general

By Elana Gotkine (HealthDay News) | June 14, 2024

FRIDAY, June 14, 2024 (HealthDay News) -- There is no evidence to suggest that administration of live vaccines to patients receiving dupilumab is unsafe, and vaccine efficacy is not affected by dupilumab, according to a position paper published online June 5 in the Annals of Allergy, Asthma & Immunology.

Noting that dupilumab targets the interleukin (IL)-4 receptor alpha subunit, blocking the effects of IL-4 and IL-13, and that clinical trials did not allow for patients to receive live vaccines due to an abundance of caution because of its immune modulatory effects, Jay A. Lieberman, M.D., from The University of Tennessee Health Science Center in Memphis, and colleagues conducted a systematic review of the literature on the safety and efficacy of vaccinations in patients receiving dupilumab and provided expert guidance for vaccine receipt.

The researchers found that live vaccines are safe based on the available literature on patients who received vaccinations while on dupilumab. In general, vaccine efficacy was not affected by dupilumab. The use of vaccines was agreed to be likely safe and effective.

"While the systematic review and expert consensus do not support any demonstrated or theoretical safety concern, robust studies in large patient numbers that could support a narrow confidence interval indicating safety do not exist," the authors write. "Furthermore, such studies are unlikely to be conducted or funded, which complicates the ability to alter regulatory agencies' recommendations on administering live vaccines to patients on dupilumab."

Several authors disclosed ties to Sanofi and Regeneron, the manufacturers of dupilumab.

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