Case Study: A Single Drug for Multiple Allergies
People who have atopic dermatitis, a type of eczema that causes red, itchy skin, often have other allergic diseases. It can be tricky to treat all of these diseases at once – in part because drugs are tested against a single disease at a time. A recent case study published by researchers at the University of Rochester Medical Center suggests that a single drug – dupilumab – may be effective in treating multiple allergic diseases at once.
Dupilumab, a monoclonal antibody that can be delivered in a shot like a vaccine, is already approved by the U.S. Food and Drug Administration to treat atopic dermatitis, asthma and chronic inflammation of the sinuses and nose - but only separately. Little was known about how dupilumab would fare against multiple allergic diseases until a case study led by URMC Dermatology Professor Lisa Beck, M.D., was published in JAAD Case Reports, the Journal of the American Academy of Dermatology.
The study followed a nine-year-old boy who sought treatment for an uncontrolled case of atopic dermatitis. With constant itching, the boy frequently lost sleep, missed school, had difficulty concentrating and his self-esteem suffered as well.
On top of atopic dermatitis, the boy also had asthma, food and environmental allergies and a few other allergic diseases, including eosinophilic esophagitis, which is chronic inflammation of the esophagus that can cause difficulty swallowing.
Through a clinical trial, the boy was treated with dupilumab, which drastically improved not only his atopic dermatitis, but several of this other allergic diseases. After 32 weeks in the trial, he was able to stop using his asthma inhaler and esophagitis medications and greatly reduced the use of his other allergy medications. His quality of life also greatly improved with less itching, uninterrupted sleep 95 percent of the time, and improved concentration and confidence.
“Prior to receiving dupilumab, our patient was suffering; he was constantly itchy, unable to concentrate or sleep well, and even missed days of school because of eczema flares,” said Fatima Bawany, a URMC medical student who conducted this study while in the UR CTSI’s Academic Research Track program. “After receiving dupilumab, not only did these eczema symptoms improve, but surprisingly, the other chronic allergic diseases that he had for years also improved. As a medical student, this was incredible to see, as it showed me the exciting frontiers that lie ahead for research on dupilumab and similar therapies.”
When the boy aged out of the clinical trial at 12 years old, he was continued on dupilumab and his allergic conditions continued to be held at bay.
Though the case report only tells the story of a single patient, it suggests dupilumab may be a good treatment choice for patients with multiple concurrent allergic conditions. Because it is safe, well-tolerated and easy to administer, study authors believe dupilumab could offer effective, long-term relief for these hard-to-treat patients.
Read the full JAAD Case Reports study.
You can also learn more about sleep disturbances caused by atopic dermatitis as well as how to prevent this inflammatory disease in two recent reviews published by Bawany.
Bawany's work was supported by the Academic Research Track Program under the University of Rochester CTSA award number TL1 TR002000 from the National Center for Advancing Translational Sciences of the National Institutes of Health. The Academic Research Track Program allows first, second and third year medical students to take a “year out” from their medical training to gain research experience.
Susanne Pritchard Pallo |