Dupilumab shows promise in bullous pemphigoid

Use of dupilumab appears to confer benefits in patients with bullous pemphigoid (BP), results of a recent study have shown. Treatment has resulted in disease clearance or satisfactory response in majority of the patients, including those in whom previous conventional therapy has failed.

The investigators carried out a case series of patients from five academic centres receiving dupilumab for BP. Patients were included if they had a clinical diagnosis of BP confirmed by lesional skin biopsy assessed by one of the following: hematoxylin and eosin staining, direct immunofluorescence, or enzyme-linked immunosorbent assay for BP180 or BP230, or both.

Thirteen patients (mean age, 76.8 years) met the eligibility criteria. Their average duration of BP prior to dupilumab initiation was 28.8 months (range, 1–60 months). Twelve of 13 patients (92.3 percent) achieved either disease clearance or satisfactory response.

Satisfactory response was defined as clinician documentation of disease improvement and patient desire to continue using the medication without documentation of disease clearance.

More than half of the patients (7/13, 53.8 percent) achieved total clearance of the BP. Of note, no adverse events were reported.

The study was limited by its small sample size, lack of a control group, lack of a standardized assessment tool, and lack of standardized safety monitoring.

“BP is an autoimmune blistering disorder occurring mostly in the elderly that lacks adequate treatments,” the investigators said.