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Severe atopic dermatitis: Dupilumab is not just safer, but more efficient
Mara Giavina-Bianchi1, Luiz Vicente Rizzo2, Pedro Giavina-Bianchi3
1Department of Dermatology, Faculdade de Medicina da Universidade de São Paulo, Brazil; Division of Clinical Immunology and Allergy, Faculdade de Medicina da Universidade de São Paulo, Brazil.
Abstract:
Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by relapsing eczema and pruritus. Until the development of Dupilumab, a new monoclonal antibody targeting IL-4 and IL-13 receptors, the current treatment of severe cases was based on immunosuppressant agents. Our main goal was to build a case series of five patients with severe atopic dermatitis, who were using immunosuppressive drugs with significant adverse effects and only partially controlled AD, and compare their symptoms, SCORAD index, treatment regimens, total and specific IgE, and blood cell count before and after the introduction of Dupilumab. SCORAD index and topical corticosteroids used on a daily basis had a significant decrease after 16 weeks of Dupilumab. Adverse effects were mild: conjunctivitis, local reaction and regional dermatosis. All patients with severe atopic dermatitis achieved better control of AD with Dupilumab than with immunosuppressive drugs. Adverse effects, secondary infections, total and specific IgE levels were greatly reduced.

