Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
J Am Acad Dermatol. 2021 May;84(5):1339-1347. doi: 10.1016/j.jaad.2021.01.012. Epub 2021 Jan 8.
Neither dupilumab-associated facial erythema nor neck erythema was reported in phase 3 clinical trials for the treatment of atopic dermatitis, but there have been a number of reports of patients developing this adverse event in clinical practice.
To outline all cases of reported dupilumab-associated facial or neck erythema to better characterize this adverse event, and identify potential etiologies and management strategies.
A search was conducted on EMBASE and PubMed databases. Two independent reviewers identified relevant studies for inclusion and performed data extraction.
A total of 101 patients from 16 studies were reported to have dupilumab-associated facial or neck erythema. A total of 52 of 101 patients (52%) had baseline atopic dermatitis facial or neck involvement and 45 of 101 (45%) reported different cutaneous symptoms from preexisting atopic dermatitis, possibly suggesting a different etiology. Suggested etiologies included rosacea, allergic contact dermatitis, and head and neck dermatitis. Most commonly used treatments included topical corticosteroids, topical calcineurin inhibitors, and antifungal agents. In the 57 patients with data on the course of the adverse events, improvement was observed in 29, clearance in 4, no response in 16, and worsening in 8. A total of 11 of 101 patients (11%) discontinued dupilumab owing to this adverse event.
Limited diagnostic testing, nonstandardized data collection and reporting across studies, and reliance on retrospective case reports and case series.
Some patients receiving dupilumab develop facial or neck erythema that differs from their usual atopic dermatitis symptoms. Prompt identification and empiric treatment may minimize distress and potential discontinuation of dupilumab owing to this adverse event.
在治疗特应性皮炎的 3 期临床试验中，均未报告度普利尤单抗相关的面部红斑或颈部红斑，但在临床实践中有许多患者出现这种不良反应的报告。
概述所有报告的度普利尤单抗相关的面部或颈部红斑病例，以更好地描述这种不良反应，并确定潜在的病因和管理策略。
在 EMBASE 和 PubMed 数据库中进行检索。两名独立的审查员确定了纳入的相关研究，并进行了数据提取。
共 16 项研究报告了 101 例度普利尤单抗相关的面部或颈部红斑患者。101 例患者中共有 52 例（52%）基线时存在特应性皮炎的面部或颈部受累，45 例（45%）报告了与原有特应性皮炎不同的皮肤症状，可能提示不同的病因。推测的病因包括酒渣鼻、过敏性接触性皮炎和头颈部皮炎。最常使用的治疗方法包括局部皮质类固醇、局部钙调磷酸酶抑制剂和抗真菌药物。在 57 例有不良反应病程数据的患者中，观察到 29 例改善，4 例痊愈，16 例无反应，8 例恶化。共有 11 例（11%）患者因该不良反应停用度普利尤单抗。
研究间诊断检测有限、数据收集和报告不标准化，以及依赖于回顾性病例报告和病例系列。
一些接受度普利尤单抗治疗的患者出现了不同于其常见特应性皮炎症状的面部或颈部红斑。及时识别和经验性治疗可能会减轻这种不良反应带来的痛苦，并潜在减少因该不良反应而停用度普利尤单抗的情况。
