Strategies for Tapering the Dosage of Biologics Targeting Type 2 Inflammation: A Systematic Review

This review evaluates current evidence on tapering strategies for anti-type 2 biologics in chronic inflammatory diseases. Given the need for long-term treatment, optimizing dosage without compromising efficacy is essential for sustainable disease management.

Biologic dose reduction strategies, such as tapering, de-escalation, dose spacing and interval dose prolongation, are increasingly explored in various type 2 inflammatory diseases, particularly in real-life settings. Studies have shown variable outcomes depending on disease type, patient characteristics, and tapering methods. Nineteen studies met inclusion criteria in this systematic review. The evidence supports the feasibility of dose tapering, especially for dupilumab, in maintaining disease control while reducing drug exposure. However, standardized tapering protocols and clear patient selection criteria remain lacking. Further prospective, controlled studies are needed to define optimal, safe, and personalized de-escalation strategies for long-term management of type 2 inflammatory diseases.