Dupilumab Facial Redness (DFR): A Newly Identified Side Effect of Dupilumab Treatment 度普利尤单抗面部红斑(DFR): Dupilumab 治疗的新发现副作用

Dupilumab (Dupixent), biological immunosuppressant, is a medication used to treat moderate-to-severe atopic dermatitis (eczema). While it is generally effective, some patients have reported an unexpected side effect: redness on the face and neck, known as Dupilumab Facial Redness (DFR). This side effect was not found in early clinical trials but has been increasingly reported in real-world treatment [1].

Occurrence Rate and Prevalence

The occurrence of Dupilumab Facial Redness (DFR) varies across studies:

  • A retrospective chart review identified DFR in approximately 10.6% of patients receiving dupilumab for atopic dermatitis (AD) [2].
  • A real-world study reported DFR in 8% of patients with a median onset of 8 weeks after starting treatment [3].
  • Another study found that 12.9% of patients developed DFR, with a median age of 29.5 years [4].

Onset Time

The time to onset of DFR after initiating dupilumab treatment also varies:

  • A systematic review of 101 patients found a mean onset time of 11 weeks [1].
  • In a study of 13 patients, DFR occurred between 8 and 20 weeks after starting treatment [5].
  • Another report noted a mean onset time of approximately 65.4 days (about 9.3 weeks), with some cases occurring as late as 8.5 months after initiation [6]. 

Conclusion

DFR is a recognized adverse effect of dupilumab, with prevalence rates ranging from approximately 8% to 12.9% across different studies. The onset typically occurs between 8 to 11 weeks after starting treatment, though it can vary. Clinicians should monitor patients for this side effect and manage it appropriately to ensure optimal treatment outcomes.

 

度普利尤单抗脸部红斑（DFR）：发生率、流行情况及发病时间

度普利尤单抗Dupilumab（商品名：Dupixent）是一种生物免疫抑制剂，用于治疗中度至重度特应性皮炎（湿疹）。尽管其治疗效果良好，但一些患者报告了一种意想不到的副作用——脸部和颈部发红，称为度普利尤单抗脸部红斑（DFR）。这种副作用在早期的临床试验中未被发现，但在真实世界的治疗过程中，越来越多的病例被报道[1]。

DFR 发生率及流行情况

关于 Dupilumab 相关脸部红斑（DFR）的发生率，不同研究结果有所不同：

  • 一项回顾性病例研究发现，大约 10.6% 的特应性皮炎（AD）患者在使用 Dupilumab 后出现 DFR[2]。
  • 一项真实世界研究报告称，约 8% 的患者在接受 Dupilumab 治疗后出现 DFR，中位发病时间为 8 周[3]。
  • 另一项研究发现，12.9% 的患者出现 DFR，患者的中位年龄为 29.5 岁[4]。

DFR 的发病时间

DFR 在使用 Dupilumab 治疗后的发病时间因患者而异，研究数据显示：

  • 一项系统性综述分析了 101 例患者，发现平均发病时间为 11 周[1]。 
  • 一项针对 13 名患者的研究发现，DFR 的发病时间介于 8 至 20 周之间[5]。
  • 另一份报告指出，DFR 的平均发病时间约为 65.4 天（约 9.3 周），部分病例甚至在 8.5 个月后才出现[6]。

结论

DFR 是Dupilumab 的已知副作用，在不同研究中，其发生率约为 8% 至 12.9%。DFR 通常在开始治疗后的 8 至 11 周之间出现，但个别患者的发病时间可能有所不同。临床医生应密切监测患者是否出现该副作用，并采取适当的管理措施，以确保最佳治疗效果。

.

Reference

  1. Hara S, Itonaga T, Nishino M, Yanagida N, Sato S, Ebisawa M. Facial redness in Japanese adolescents with atopic dermatitis treated with dupilumab: A case series. J Allergy Clin Immunol Glob. 2023 Mar 21;2(2):100096.
  2. Waldman RA, DeWane ME, Sloan B, Grant-Kels JM. Characterizing dupilumab facial redness: A multi-institution retrospective medical record review. J Am Acad Dermatol. 2020 Jan;82(1):230-232.
  3. Metko, Dea et al. A real-world study of dupilumab in patients with atopic dermatitis including patients with malignancy and other medical comorbidities JAAD International, Volume 15, 5 – 11
  4. Ordóñez-Rubiano MF, Casas M, Balaguera-Orjuela V, et al. Dupilumab facial redness:Clinical characteristics and proposed treatment in a cohort. Dermatol Ther. Published online September 21, 2021. doi:10.1111/dth.15140
  5. Camela, E., Giampetruzzi, A. R., De Pità, O., Pallotta, S., & Russo, F. (2024). Dupilumab in real-life settings: a review of adverse events and their pathogenesis. Expert Opinion on Drug Safety, 23(4), 439–447.
  6. Devani D, Chakraborty D, De A (October 03, 2024) Dupilumab Facial Redness (DFR) Cleared With Oral Itraconazole. Cureus 16(10): e70780. doi:10.7759/cureus.70780
  7. Jo CE, Finstad A, Georgakopoulos JR, Piguet V, Yeung J, Drucker AM. Facial and neck erythema associated with dupilumab treatment: A systematic review. J Am Acad Dermatol. 2021 May;84(5):1339-1347.