Patch tests remain effective in atopic dermatitis patients treated with dupilumab
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Key takeaways:
- A study explored patch test results of dupilumab in atopic dermatitis.
- The use of dupilumab did not greatly affect patch tests for allergens.
Patients being treated for atopic dermatitis with dupilumab had good reproducibility with patch testing for allergic contact dermatitis, according to a study.
“Dupilumab (DUPI) is a monoclonal antibody that blocks the interleukin (IL)-4 and -13 signals of the T-helper type-2 (TH2) pathway. DUPI is licensed to treat moderate to severe atopic dermatitis (AD). Its impact on patch test (PT) results and its efficacy against allergic contact dermatitis (ACD) is not yet well known,” Sarah Bocquel, MD, of Nantes University Hospital, France, and colleagues wrote. “AD pathophysiology during its chronic phase is mainly based on the TH2 pathway, while that of ACD implicates the TH1 pathway.”
The prospective, multicenter study included 76 patients who were taking dupilumab and had undergone patch tests at least 4 months after starting treatment.
Patients were issued standardized anonymous questionnaires when they began dupilumab, when they received the patch test and at an optional third visit several weeks after testing.
Of the 76 patients in the study, 36% had allergic contact dermatitis occurrences before treatment. Partial responses to dupilumab occurred in 88% of patients, with 11% experiencing worsening AD.
Positive PT reactions occurred in 36 patients (47%), with some having several positive reactions, totaling 142 positive results.
When comparing PT results before and during dupilumab treatment, 1,022 of the 1,230 paired allergens were the same, 34 were positive, 44 were lost and 130 were uninterpretable.
The optional third visit was completed by 16 patients, with five experiencing dermatitis regression after allergen avoidance.
“We confirm that PTs are often positive and relevant for DUPI-treated AD patients,” the authors wrote. “PT reproducibility on DUPI seems to have been preserved within the limits of this study.”