Case Series: Combination of dupilumab and omalizumab as a way to reduce dupilumab-associated adverse events in severe atopic dermatitis

TL;DR

This case series explores combining dupilumab and omalizumab to reduce side effects in severe atopic dermatitis patients.

Contribution

The study proposes a novel combination therapy to mitigate dupilumab-associated adverse events in atopic dermatitis.

Findings

Combining dupilumab with omalizumab may reduce adverse events like conjunctivitis and dermatitis.

Patients reluctant to discontinue dupilumab due to side effects may benefit from this combined treatment approach.

Abstract

Dupilumab is a fully human monoclonal antibody directed against the interleukin-4 receptor subunit α, the common chain of the IL-4 and IL-13 receptors. Dupilumab has been demonstrated to be highly effective in the treatment of severe atopic dermatitis, asthma, and chronic rhinosinusitis with nasal polyps. Despite the favorable tolerability of dupilumab, several publications and reviews have reported various adverse events, including conjunctivitis, keratitis, and face and neck treatment-resistant dermatitis, which reduce patients’ quality of life and may necessitate the cancellation of therapy. The current standard of care for severe chronic diseases involves a collaborative approach between the patient and their physician. The majority of patients who respond well to this type of systemic atopic dermatitis (AtD) therapy are reluctant to interrupt dupilumab treatment due to the previously mentioned adverse events. The combination of dupilumab and anti-IgE therapy (omalizumab) may be beneficial for individuals who undergo dupilumab treatment for AtD and experience severe adverse events.