Dupilumab beneficial in treatment of bullous pemphigoid

Treatment with dupilumab appears to be safe and effective in the treatment of patients with bullous pemphigoid (BP), yielding significant improvements in symptoms with a favourable safety profile, according to a study.

For the study, researchers looked at the medical records of 146 adult patients with BP (mean age 73 years, 58.9 percent men) who received 300 mg of dupilumab every 2 weeks following an initial dose of 600 mg. The median follow-up period was 24.6 weeks.

Of the patients, 87.0 percent achieved disease control with dupilumab within 4 weeks, the primary study outcome. The median time to disease control following treatment was 14 days.

A total of 35.6 percent of patients achieved complete remission, while 8.9 percent relapsed during the observation period. The complete remission rate and cumulative relapse rate at week 64 were 62.5 percent and 30.9 percent, respectively.

Additionally, treatment led to rapid and sustained improvement in clinical indicators and laboratory examination results, including Bullous Pemphigoid Disease Area Index (BPDAI) scores, itching numerical rating scale (NRS) scores, serum anti-BP180 and anti-BP230 antibodies, total IgE levels, and eosinophil count.

The most common adverse events (AE)s were infections and eosinophilia, but the majority of patients (73.3 percent) did not report any AEs. Serum anti-BP180 antibody levels of >50 relative units (RU)/mL predicted 4-week disease control (OR, 3.63, 95 percent confidence interval [CI], 0.97–12.61; p=0.045), while male sex was associated with greater risk of relapse (HR, 10.97, 95 percent CI, 1.42–84.92; p=0.02).

The findings indicate that female BP patients and those with anti-BP180 antibody levels of at least 50 RU/mL may respond better with dupilumab.