D1.386 - Impact of dupilumab on allergen specific immunoglobulin E production
Background
Total IgE production has been noted to substantially decline under the influence of dupilumab. This is the consequence of blocking binding of IL-4 to IL-4 receptor alpha. The impact of this agent on production of allergen specific IgE has not been reported.
Method
An index case was noted wherein almost complete abrogation of allergen specific Immunoglobulin E occurred over the course of utilization of several biologics including dupilumab. Two cases were reviewed wherein allergen specific IgE had been obtained pre-and post-long-term dupilumab treatment.
Results
Dupilumab was used on a continuous basis for five years in case one. Total IgE declined from 2954 to 233 over this time. Allergen specific immunoglobulin E declined from class five to class three for dust mite; from class three and four to class two for grass; from class three and class four to class one and class two for weed; and from class four and class three to class two and class three for tree; and class four and five to class three for dander. In case two who received dupilumab for three years, total IgE declined from 322 to 25; allergen specific IgE declined from class five to class two for dust; from class two to class 0/1 for grass; from class 0/1 to 0 from mold; from class one to zero for tree; and class 0/1 to 0 for weed.
Conclusion
Dupilumab can successfully reduce allergen specific IgE and by implication atopic status in patients who receive long-term treatment from 3 to 5 years in duration.
