Lobo Yolanka, Lee Ruby C, Spelman Lynda
Veracity Clinical Research, Brisbane, Queensland, Australia.
Gabba Dermatology, Brisbane, Queensland, Australia.
Case Rep Dermatol. 2021 May 4;13(2):248-256. doi: 10.1159/000515246. eCollection 2021 May-Aug.
Dupilumab is currently the only biologic treatment approved for moderate-to-severe atopic dermatitis. Though limited, available clinical data describing dupilumab use in pregnancy have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Systemic treatment in pregnant women with atopic dermatitis is currently restricted to corticosteroids, cyclosporine A, and azathioprine. Atopic dermatitis often has a deleterious course in pregnancy which can cause substantial distress and significantly impact on global health and quality of life. We report a case of severe atopic dermatitis treated safely with dupilumab during pregnancy with no adverse maternal or fetal outcomes observed. Our case highlights that dupilumab use in pregnancy has its place but should always be preceded by careful assessment of the risks and benefits. Clinicians are encouraged to enroll their patients in relevant pregnancy registry studies to monitor outcomes in women exposed to dupilumab during pregnancy and lactation.
度普利尤单抗是目前唯一被批准用于中重度特应性皮炎的生物治疗药物。尽管关于度普利尤单抗在孕期使用的现有临床数据有限,但尚未发现与药物相关的重大出生缺陷、流产或不良母婴结局风险。目前,患有特应性皮炎的孕妇的全身治疗仅限于使用皮质类固醇、环孢素A和硫唑嘌呤。特应性皮炎在孕期通常病程不佳,可导致极大痛苦,并对整体健康和生活质量产生重大影响。我们报告了一例在孕期使用度普利尤单抗安全治疗重度特应性皮炎的病例,未观察到不良母婴结局。我们的病例表明,孕期使用度普利尤单抗有其合理性,但在使用前应始终仔细评估风险和益处。鼓励临床医生让其患者参加相关的孕期登记研究,以监测孕期和哺乳期接触度普利尤单抗的女性的结局。