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Dupilumab as a novel therapy for bullous pemphigoid: A multicenter case series - 19/06/20

Doi : 10.1016/j.jaad.2020.01.089 
Rana Abdat, MD a, Reid A. Waldman, MD b, Valeria de Bedout, MD c, Annette Czernik, MD d, Michael Mcleod, MD a, Brett King, MD e, Samantha Gordon, MD a, Razzaque Ahmed, MD a, Anna Nichols, MD, PhD c, Marti Rothe, MD b, David Rosmarin, MD a,
a Department of Dermatology, Tufts Medical Center, Boston, Massachusetts 
b Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut 
c Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Health System, Miami, Florida 
d Department of Dermatology, Mount Sinai Health System, New York, New York 
e Department of Dermatology, Yale School of Medicine, New Haven, Connecticut 

Correspondence to: David Rosmarin, MD, Tufts Medical Center, 800 Washington St, Boston, MA, 02111.Tufts Medical Center800 Washington StBostonMA02111

Abstract

Background

Bullous pemphigoid (BP) 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 BP.

Methods

This is a case series of patients from 5 academic centers receiving dupilumab for BP. Patients were eligible if they had a clinical diagnosis of BP confirmed by lesional skin biopsy evaluated by one of more of the following: hematoxylin and eosin staining, direct immunofluorescence, or enzyme-linked immunosorbent assay for BP180 or BP230, or both.

Results

We identified 13 patients. Patients were an average age of 76.8 years, and the average duration of BP before dupilumab initiation was 28.8 months (range, 1-60 months). Disease clearance or satisfactory response was achieved in 92.3% (12 of 13) of the patients. Satisfactory response was defined as clinician documentation of disease improvement and patient desire to stay on the medication without documentation of disease clearance. Total clearance of the BP was achieved in 53.8% (7of 13) of patients 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.

Conclusion

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

Le texte complet de cet article est disponible en PDF.

Key words : autoimmune blistering diseases, biologics, bullous disorders, bullous pemphigoid, dupilumab, medications, treatment

Abbreviations used : BP, CCL, IL, SC


Plan


 Drs Abdat and Waldman contributed equally to this article.
 Funding sources: None.
 Conflicts of interest: Dr Rosmarin has received honoraria as a consultant for AbbVie, Celgene, Dermavant, Dermira, Janssen, Lilly, Novartis, Pfizer, Regeneron Pharmaceuticals, Sanofi, and Sun Pharmaceuticals; research support from AbbVie, Bristol-Myers Squibb, Celgene, Dermira, Incyte, Janssen, Lilly, Merck, Novartis, Pfizer, and Regeneron Pharmaceuticals; and has served as a paid speaker for AbbVie, Celgene, Janssen, Lilly, Novartis, Pfizer, Regeneron Pharmaceuticals, and Sanofi. Dr Nichols has been a consultant for Almirall and Boehringer Ingelheim; and an investigator for Trevi, AbbVie, Boehringer Ingelheim, and Novartis; and starting up a study with Regeneron Pharmaceuticals. Dr King is on the speakers bureau for Pfizer Inc, Regeneron Pharmaceuticals, and Sanofi Genzyme; is an investigator for Concert Pharmaceuticals Inc, Eli Lilly and Company, and Pfizer Inc; and is a consultant to and/or has served on advisory boards for Aclaris Therapeutics, Arena Pharmaceuticals, Concert Pharmaceuticals Inc, Dermavant Sciences, Eli Lilly and Company, and Pfizer Inc. Dr Czernik served as speaker for Genentech. Drs Abdat, Waldman, de Bedout, Mcleod, Gordon, Ahmed, and Rothe have no conflicts of interest to declare.
 IRB approval status: The Tufts University Health Sciences Investigational Review Board approved this case series.
 Reprints not available from the authors.


© 2020  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 83 - N° 1

P. 46-52 - juillet 2020 Retour au numéro
Article précédent Article précédent
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