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度普利尤单抗治疗特应性皮炎:我们一直在寻找的万灵药?

Dupilumab for Atopic Dermatitis: The Silver Bullet We Have Been Searching for?

作者信息

Tameez Ud Din Ahsan, Malik Ifrah, Arshad Daneyal, Tameez Ud Din Asim

机构信息

Internal Medicine, Rawalpindi Medical University, Rawalpindi, PAK.

出版信息

Cureus. 2020 Apr 6;12(4):e7565. doi: 10.7759/cureus.7565.

Abstract

Atopic dermatitis is a chronic inflammatory condition of the skin affecting a large number of people worldwide. Historically, this condition has been managed by topical corticosteroids and general skincare measures. The inadequacy of these management strategies has always driven efforts to find better drugs. Dupilumab has been recently approved for the management of atopic dermatitis. It is a human monoclonal antibody that inhibits the binding of key interleukins involved in the pathogenesis of atopic dermatitis, thus blocking the signaling mechanisms and disrupting the disease progression. Dupilumab reduces the severity and associated symptoms of atopic dermatitis. It improves the life quality of patients and reduces the anxiety associated with the disease. Combination therapy of dupilumab and topical corticosteroids is more effective than dupilumab monotherapy. The treatment-related adverse events include headache, injection site reaction, conjunctivitis, nasopharyngitis, and herpes viral infections. Moreover, the simultaneous use of live vaccines with dupilumab is contraindicated. It is also beneficial in the management of asthma, chronic rhinosinusitis, and eosinophilic esophagitis. In this review, we have discussed the clinical efficacy and safety profile of dupilumab in the management of atopic dermatitis.

摘要

特应性皮炎是一种慢性皮肤炎症性疾病,影响着全球大量人群。从历史上看,这种疾病一直通过外用糖皮质激素和一般护肤措施来治疗。这些管理策略的不足一直推动着人们努力寻找更好的药物。度普利尤单抗最近已被批准用于治疗特应性皮炎。它是一种人源单克隆抗体,可抑制参与特应性皮炎发病机制的关键白细胞介素的结合,从而阻断信号传导机制并干扰疾病进展。度普利尤单抗可减轻特应性皮炎的严重程度及相关症状。它提高了患者的生活质量,并减轻了与该疾病相关的焦虑。度普利尤单抗与外用糖皮质激素的联合治疗比度普利尤单抗单药治疗更有效。与治疗相关的不良事件包括头痛、注射部位反应、结膜炎、鼻咽炎和疱疹病毒感染。此外,度普利尤单抗禁忌与活疫苗同时使用。它在哮喘、慢性鼻-鼻窦炎和嗜酸性食管炎的治疗中也有益处。在本综述中,我们讨论了度普利尤单抗治疗特应性皮炎的临床疗效和安全性。

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