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Dupilumab-induced hypereosinophilia: review of the literature and algorithm proposal for clinical management

2022; Taylor & Francis; Volume: 16; Issue: 7 Linguagem: Inglês

10.1080/17476348.2022.2090342

1747-6356

Marco Caminati, Bianca Olivieri, Annarita Dama, Claudio Micheletto, Pierluigi Paggiaro, Patrick Pinter, Gianenrico Senna, Michele Schiappoli,

Eosinophilic Esophagitis

Introduction Dupilumab is a human monoclonal antibody that targets both IL-4 and IL-13 signaling. It is currently indicated for the treatment of asthma, moderate-to-severe atopic dermatitis, and chronic rhinosinusitis with nasal polyps (CRSwNP). Eosinophilia has been reported as a potential adverse event in treated patients.Areas covered A selective search on PubMed and Medline up to January 2022 was performed, by focusing on dupilumab-induced hypereosinophilia described in clinical trials, real-life studies, and case reports. The possible mechanisms underlying dupilumab-induced hypereosinophilia and the eosinophil-related morbidity have also been explored.Expert opinion Dealing with dupilumab-induced hypereosinophilia represents a clinical challenge for clinicians managing patients on dupilumab therapy. An algorithm for the practical management of dupilumab-induced hypereosinophilia has been proposed, in order to properly investigate potential eosinophil-related morbidity and avoid unnecessary drug discontinuation.