Dupilumab, an IL-4/13 antagonist, was approved as the first biologic for atopic dermatitis in 2017. This study thoroughly examines intriguing new findings on dupilumab that have been published since the drug’s approval. The daily clinical practise reports of dupilumab in atopic dermatitis are positive and consistent with the registration studies. Dupilumab appears to have no deleterious effects on the pharmacokinetics of CYP450-metabolized medicines or immunisation reactions. Dupilumab therapy reduces type 2 inflammatory biomarkers in the skin and serum. Dupilumab increases the incidence of conjunctivitis, particularly in patients with severe atopic dermatitis and a history of conjunctivitis, however the underlying processes are unknown. Dupilumab has been shown to be beneficial in cases of treatment-refractory hand eczema and prurigo nodularis; however, there are contradictory responses to dupilumab in allergic contact dermatitis and alopecia areata, which may be due to pathophysiological heterogeneity.

The ongoing use of dupilumab for atopic dermatitis is supported by daily practise data. The only warning indication is an elevated risk of conjunctivitis; mechanistic research into dupilumab-associated conjunctivitis should lead to risk-mitigation measures. Prospective, controlled trials of dupilumab in hand eczema and prurigo nodularis are required. To evaluate dupilumab for illnesses with diverse pathophysiologies, such as alopecia areata and allergic contact dermatitis, a precision medicine-driven drug-development approach is required.

Reference: https://journals.lww.com/co-allergy/Abstract/2019/08000/Dupilumab_after_the_2017_approval_for_the.12.aspx