An observation of weight gain in patients with atopic dermatitis receiving dupilumab

Atopic dermatitis (AD) is a chronic inflammatory skin condition driven by immune dysregulation, particularly T helper 2-mediated cytokines such as interleukin (IL) 4 and IL-13. Dupilumab, a monoclonal antibody targeting the IL-4 receptor alpha subunit, has emerged as an effective therapy for moderate-to-severe AD. However, emerging evidence suggests a potential association between dupilumab and weight gain, likely due to the metabolic role of IL-4.

To evaluate weight changes in patients with AD undergoing dupilumab therapy.

We conducted a retrospective chart review of patients who were prescribed dupilumab between April 2018 and December 2023. Inclusion criteria required dupilumab treatment for > 6 months with documented weight measurements within 3 months before treatment initiation and at 3-6 months after initiation. Thirty patients met inclusion criteria. Demographic data, prior treatments, disease severity and weight changes were analysed.

Of the 30 patients, 21 were men and 9 were women, with a mean age of 40.1 years. The mean (SD) baseline weight was 81.5 (17.3) kg. Twenty patients (67%) experienced weight gain, with a mean increase of 5.9 (3.3) kg. Seven patients (23%) had no weight change, and three (10%) lost weight [mean loss 3.7 (3.8) kg]. The overall mean weight gain was 3.6 (4.5) kg.

Our findings suggest that dupilumab treatment in AD may be associated with weight gain in a subset of patients. Given the emerging role of IL-4 in metabolic regulation, further prospective studies are warranted to clarify the mechanism and clinical significance of this potential adverse effect.