Dupilumab and COVID‐19: What should we expect?

Coronavirus disease 2019 (COVID‐19) is a pandemic disease caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) with high morbidity and mortality. There are very limited data on the interference of immunomodulating drugs on the risk of infection and on the course of the disease. In...

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Bibliographic Details
Published in:Dermatologic Therapy 2020-07, Vol.33 (4), p.e13502-n/a
Main Authors: Patruno, Cataldo, Stingeni, Luca, Fabbrocini, Gabriella, Hansel, Katharina, Napolitano, Maddalena
Format: Article
Language:English
Subjects:
adult atopic dermatitis
Antibodies, Monoclonal, Humanized - therapeutic use
Betacoronavirus
Coronavirus Infections - drug therapy
COVID-19
dupilumab
Humans
Immunotherapy
Interleukin-4 Receptor alpha Subunit
Monoclonal antibodies
Pandemics
Pneumonia, Viral - drug therapy
SARS-CoV-2
Short Paper
Short Papers
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Summary:Coronavirus disease 2019 (COVID‐19) is a pandemic disease caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) with high morbidity and mortality. There are very limited data on the interference of immunomodulating drugs on the risk of infection and on the course of the disease. In particular, there are no current clinical data about the interference exerted by dupilumab, a biologic drugs blocking IL‐4 and IL‐13, used for adult atopic dermatitis. The pathogenesis of COVID‐19 is complex, characterized by an immune response mainly Th1/Th17. The hyper‐activation of these cells may cause the release of pro‐inflammatory cytokines that may result in lung impairment. IL‐4 and IL‐13 are Th2 cytokines, thus being part of a pathway not considered implicated in host defense mechanism against viral infections. Indeed, viral infections, including respiratory infections, have not been reported as a significant adverse event in clinical trials. Furthermore, dupilumab has been proved to be efficacious also in exacerbations of asthma, and it is known that viral infections can worsen asthma. Therefore, the current data seem to suggest that treatment with dupilumab should not be stopped during COVID‐19 pandemic. Obviously, a careful assessment is mandatory for each individual patient and further studies are necessary to characterize the immunologic responses in COVID‐19.
ISSN:1396-0296
1529-8019
DOI:10.1111/dth.13502