Long-term dupilumab therapy in atopic dermatitis and prurigo nodularis: clinical cases

Atopic dermatitis and prurigo nodularis are chronic inflammatory skin diseases characterized by intense pruritus, skin lesions that differ in their morphology and distribution, and a substantial impact on patients’ quality of life. Type 2 inflammation, mediated in part by interleukins 4 and 13, plays an important role in the pathogenesis of both diseases. Dupilumab, which blocks signaling pathways mediated by these cytokines through binding to the α-subunit of the interleukin-4 receptor, is used as targeted therapy for atopic dermatitis and prurigo nodularis. Considerable experience with long-term dupilumab therapy has accumulated in atopic dermatitis, whereas information on prolonged treatment of prurigo nodularis is based predominantly on real-world studies.

We present two clinical cases of dupilumab therapy in female patients with atopic dermatitis and prurigo nodularis. In both cases, treatment was associated with a substantial reduction in the severity of skin manifestations and pruritus, improvement in quality of life, and a reduced need for concomitant therapy. The achieved clinical response was sustained throughout the follow-up period. Dupilumab therapy was not interrupted during the entire follow-up period, and no adverse events were recorded. These clinical observations add to the available evidence on the long-term use of dupilumab in atopic dermatitis and prurigo nodularis.