Dupilumab Rapidly Reduces IgE and Eosinophil Values in Kimura Disease: Sustained Remission Achieved

Kimura disease (KD) is a rare chronic inflammatory disorder characterized by type 2 immune dysregulation. Conventional treatments have shown limited efficacy, whereas biologics targeting type 2 cytokines show therapeutic potential. This study aimed to evaluate the efficacy and safety of dupilumab, a monoclonal antibody targeting interleukin (IL) 4 and IL-13, in the treatment of KD.

A retrospective case series comprising 8 patients with KD was studied at the Allergy Clinic of the Second Affiliated Hospital of Zhejiang University School of Medicine from October 2021 to June 2024. Patients received dupilumab according to the approved regimen for atopic dermatitis, starting with a 600-mg loading dose followed by 300 mg every 2 weeks. The dosage was gradually tapered based on the clinical response to 300 mg monthly, then every 6 weeks, and finally every 2 months until the drug was eventually discontinued. Clinical outcomes, including mass reduction, serum IgE levels, eosinophil counts, and allergic comorbidities, were assessed.

Mass volume was reduced considerably in all 8 patients, with 7 achieving complete remission and 1 attaining partial remission. Both serum IgE levels and eosinophil counts decreased markedly. No clinically significant adverse drug reactions were observed. Several patients remained in remission after discontinuation, with follow-up extending up to 1 year.

Dupilumab showed rapid and sustained efficacy in KD, suggesting its potential as a disease-modifying and corticosteroidsparing treatment option. Further controlled studies are warranted to validate these findings.