Clinical Scorecard: Dupilumab Alleviates Itching in Various Dermatological Conditions: Insights from Clinical Trials on Atopic Dermatitis, Prurigo Nodularis, and Chronic Spontaneous Urticaria

At a Glance

Key Highlights

• Dupilumab combined with topical corticosteroids (TCS) shows a favorable safety profile across AD, PN, and CSU populations.
• Treatment-emergent adverse events (TEAEs) were common but mostly mild; serious adverse events (TESAEs) were infrequent.
• Injection-site reactions and conjunctivitis were among the most reported adverse events with dupilumab.

Guideline-Based Recommendations

Diagnosis

• Diagnose AD, PN, and CSU based on clinical criteria and patient history.
• Confirm chronic spontaneous urticaria diagnosis with persistence >6 weeks.

Management

• Use dupilumab as add-on therapy to low-to-medium potency topical corticosteroids or topical calcineurin inhibitors in AD and PN.
• Maintain background H1 antihistamine therapy during dupilumab treatment in CSU.
• Monitor for injection-site reactions and conjunctivitis during treatment.

Monitoring & Follow-up

• Regularly assess for treatment-emergent adverse events including nasopharyngitis, headache, and injection-site reactions.
• Monitor for serious adverse events and discontinue treatment if severe adverse reactions occur.
• Evaluate ocular symptoms suggestive of conjunctivitis and manage accordingly.

Risks

• Potential for injection-site reactions occurring in up to 15% of patients.
• Risk of conjunctivitis, including allergic and infectious types, particularly in AD patients.
• Low incidence of treatment discontinuation due to adverse events.

Patient & Prescribing Data

Patients with moderate to severe AD (N=425), PN (N=309), and CSU (N=138) enrolled in clinical trials.

Dupilumab plus TCS or H1 antihistamines demonstrated higher rates of TEAEs compared to placebo but with fewer discontinuations and serious adverse events.

Clinical Best Practices

• Maintain stable background topical corticosteroid or antihistamine therapy during dupilumab treatment.
• Educate patients on potential injection-site reactions and conjunctivitis symptoms.
• Promptly address and manage adverse events to minimize treatment discontinuation.
• Use standardized MedDRA terms for adverse event reporting to ensure consistency.

References

• Correction: Dermatol Ther (Heidelb) 2025