AD treatment during the pandemic: dupilumab does not raise COVID-19 infection risk

Patients treated with dupilumab for atopic dermatitis (AD) demonstrated a lower COVID-19 rate compared with the incidence of SARS-CoV-2 infection in the general public. This finding of a multicentre, retrospective study is consistent with existing recommendations to carry on with treatment.

As long as no signs or symptoms of a SARS-CoV-2 infection are present, the continuation of a biologic treatment with dupilumab for AD is recommended [1,2]. Also, starting an indicated therapy with the agent should not be postponed due to the COVID-19 pandemic. Yet, the discussion is still ongoing about the possible effect of biologic treatment for AD on SARS-CoV-2 infection incidence and outcome prospects [3]. To gain further insight, a Canadian, multicentre cohort study investigated patients who were followed at academic centres and community practices from 11 March 2020 until 30 April 2021. Included patients were all treated with dupilumab for AD, asthma, and/or nasal polyps at this point.

Only 0.36% of the patients contracted a SARS-CoV-2 infection (2 out of 548 participants). There was 1 asymptomatic female patient aged 13 years and 1 male patient aged 18 years, the latter presenting with classic symptoms like cough, dyspnoea, fever, and anosmia. Both did not require hospitalisation or oxygen therapy. Treatment with dupilumab was stopped for the duration of the infection and resumed after 2 weeks.

As the incidence of COVID-19 was 3.2% for the general Canadian population at the end of the study period, Dr Brian Rankin (University of Calgary, Canada) and his fellow investigators underlined that the infection rate of patients on dupilumab appears to be lower.

The study authors concluded that despite some limitations of this retrospective study, the results suggest that treatment with dupilumab does not increase the risk of SARS-CoV-2 infection or worsen its signs and/or symptoms in patients with AD, asthma, and/or nasal polyps.

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   1. Wollenberg A, et al. J Eur Acad Dermatol Venereol. 2020;34(6):e241–e242.
   2. Vultaggio A, et al. Allergy. 2020;75(11):2764–2774.
   3. Rankin BD, et al. Incidence and prognosis of COVID-19 in patients with atopic diseases on dupilumab: a multicenter retrospective cohort study. P32414, AAD 2022 Annual Meeting, 25–29 March, Boston, MA, USA.

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Posted on 18 May, 202223 May, 2022