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Graft-versus-host disease (GvHD) can present in multiple organs, with the most common first clinical manifestations often being cutaneous.1 While the number of indications for allogeneic hematopoietic stem cell transplantation (HSCT) is expanding, healthcare professionals are challenged with treating various forms of cutaneous GvHD.1 The current first-line treatment option for moderate-to-severe cutaneous GvHD is systemic corticosteroids, either alone or in combination with immunosuppressive therapies.1 A potential alternative to corticosteroids is dupilumab, a monoclonal antibody therapy targeting interleukin-4Rα.1
Here, we summarize a case series published by Belmesk et al.1 in JAAD Case Reports on the successful use of dupilumab in treating recalcitrant pediatric atopic dermatitis-like (AD-like) GvHD.
For the case series by Belmesk et al.,1 the records were assessed of patients diagnosed with AD-like GvHD, who were refractory to conventional therapies, at the Universite de Montreal, Canada.
In this case series, the effectiveness of dupilumab treatment was assessed (Table 1).
Table 1. Patients’ dermatologic severity score before and after dupilumab*
Case |
BSA (%) |
IGA score |
DLQI score |
|||
---|---|---|---|---|---|---|
Pre-treatment |
Post-treatment |
Pre-treatment |
Post-treatment |
Pre-treatment |
Post-treatment |
|
1 |
48 |
0 |
4 |
1 |
26 |
1 |
2 |
10 |
1 |
4 |
0 |
19 |
9 |
3 |
55 |
0 |
4 |
0 |
25 |
0 |
4 |
26 |
6 |
3 |
1 |
16 |
3 |
BSA, body surface area; DLQI, Dermatology Life Quality Index; IGA, Investigator Global Assessment scale. |
Figure 1. Clinical case overviews*
AD-like, atopic dermatitis-like; SC, subcutaneously; GvHD, graft-versus-host disease, HSCT, hematopoietic stem cell transplantation; MMF, mycophenolate mofetil; nbUVB, narrow-band ultraviolet B; TCI, topical corticosteroids and calcineurin inhibitors.
*Data from Belmesk L, et al.1
Key learnings1 |
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