Arthritis induced by dupilumab treatment: A case report and literature review


Creative Commons License

Bıcılıoğlu C., ONAĞ E., AKGÜL Ö.

Romanian Journal of Rheumatology, vol.33, no.4, pp.270-279, 2024 (Scopus) identifier

  • Publication Type: Article / Review
  • Volume: 33 Issue: 4
  • Publication Date: 2024
  • Doi Number: 10.37897/rjr.2024.4.6
  • Journal Name: Romanian Journal of Rheumatology
  • Journal Indexes: Scopus, Academic Search Premier, Central & Eastern European Academic Source (CEEAS), Directory of Open Access Journals
  • Page Numbers: pp.270-279
  • Keywords: dupilumab, IL-13, IL-17, IL-4, inflammatory disease-like side effects, safety, side effects
  • Open Archive Collection: AVESIS Open Access Collection
  • Manisa Celal Bayar University Affiliated: Yes

Abstract

Dupilumab is a human monoclonal IgG4 antibody targeting the interleukin-4 receptor alpha chain (IL-4Rα). It effectively inhibits the signaling pathways of both interleukin-4 (IL-4) and interleukin-13 (IL-13) and has been extensively employed in managing conditions such as atopic dermatitis, asthma, allergic rhinitis, and other allergic disorders. Despite numerous studies affirming its safety profile, suppression of IL-4 and IL-13 has been linked to an increased dominance of interleukin-17 (IL-17), which can lead to adverse effects resembling those seen in psoriatic arthritis and spondyloarthropathy-like symptoms. Through a case study of a patient receiving dupilumab for prurigo nodularis, this paper seeks to shed light on the potential inflammatory disease-like side effects associated with this treatment. Specifically, we explore manifestations such as enthesitis/arthritis, psoriasis, uveitis, inflammatory bowel disease, lupus erythematosus, and vasculitis, urging vigilance among rheumatologists and dermatologists.