Dupixent (dupilumab) / Sanofi, Regeneron - LARVOL DELTA

Acquired hemophilia A associated with amlodipine use in a hypertensive patient: A case report (ASH 2025) - "A 52-year-old male with hypertension on amlodipine and prior immune thrombocytopenia purpura secondary to dupilumab presented as transfer for upper and lower extremity swelling with anemia...He was then discharged on prednisone, cyclophosphamide, with further rituximab infusions in the outpatient setting...Given the presentation of the case, this was likely cause of his AHA.. It is essential to have a thorough work-up and history to evaluate hemophilia and to discern what steps are needed next in the care of the patient ."

Case report • Clinical • Cardiovascular • Genetic Disorders • Hemophilia • Hemophilia A • Hypertension • Immune Thrombocytopenic Purpura • Immunology • Rare Diseases • Rheumatology • Thrombocytopenia • Thrombocytopenic Purpura • HP

BH22 Alopecia areata caused by an adverse reaction to denosumab. (PubMed, Br J Dermatol) - "Alopecia areata and other autoimmune reactions have been seen with other biologic drugs, including dupilumab (interleukin-14 and interleukin-3 inhibitor) and anti-tumour necrosis factor (TNF)-α medications. Based on the timeline, it was unlikely that simvastatin had triggered the process. This case is one of only a handful of reports of denosumab inducing alopecia areata and it is important to consider this as a cause in patients taking this medication."

Journal • Alopecia • Dermatology • Dyslipidemia • Immunology • Musculoskeletal Diseases • Oncology • Orthopedics • Osteoporosis • Rheumatology

PA20 Case series: effectiveness and safety of dupilumab for liver transplant recipients in paediatric patients with eczema. (PubMed, Br J Dermatol) - "He was immunosuppressed with mycophenolate mofetil and oral tacrolimus from age 2 years...Case 4 is a 7-year-old boy with skin type VI with a liver transplant age 1 year for biliary atresia and secondary portal hypertension, and a history of immune thrombocytopenia needing intravenous immunoglobulin and rituximab...Our cohort of paediatric patients with severe eczema had liver transplantations and thus had no live vaccines throughout childhood. We report no side-effect sequelae at present."

Journal • Atopic Dermatitis • Cardiovascular • Dermatology • Hematological Disorders • Hepatology • Hypertension • Immune Thrombocytopenic Purpura • Immunology • Infectious Disease • Inflammation • Pediatrics • Portal Hypertension • Thrombocytopenia • Thrombocytopenic Purpura • Thrombosis • Transplantation

P098 Asthma control in patients receiving systemic therapy for atopic eczema: results from the UK Atopic eczema Systemic TherApy Register (A-STAR). (PubMed, Br J Dermatol) - "Treatments initiated at enrolment included dupilumab (n = 148), methotrexate (n = 66), Janus kinase inhibitors (abrocitinib or upadacitinib, n = 52) and ciclosporin (n = 37). We plan further, similar analyses on individual drug groups in relation to asthma control, as the number of A-STAR patients in individual drug groups increases over time, enhancing statistical power.TablePredictors of achieving good asthma control (Asthma Control Test 20-25) at week 16 in multivariable analysisVariableAdjusted odds ratio (95% confidence interval)aDrug groupJanus kinase inhibitors1 (reference)Ciclosporin3.32 (0.69-17.0)Dupilumab3.34 (1.28-9.03)*Methotrexate2.89 (0.78-11.4)Baseline asthma control test score1.31 (1.20-1.45)**P < 0.05. aAdjusted for baseline Eczema Area and Severity Index and Patient-Oriented Eczema Measure, number of prior oral systemic treatments, sex, age of atopic eczema onset, age of drug initiation and Fitzpatrick skin type."

Journal • Asthma • Atopic Dermatitis • Dermatology • Immunology • Pulmonary Disease • Respiratory Diseases

P109 Lebrikizumab for the treatment of moderate-to-severe atopic eczema: real-world experience from a tertiary centre. (PubMed, Br J Dermatol) - "Ten patients experienced ocular symptoms while on dupilumab (n = 8) or tralokinumab (n = 3). Moreover, lebrikizumab serves as a viable alternative for patients who experienced ocular complications with previous biologic therapies. Further long-term follow-up is essential in larger cohorts to fully assess the future role of lebrikizumab."

Journal • Real-world evidence • Retrospective data • Atopic Dermatitis • Conjunctivitis • Dermatitis • Dermatology • Dry Eye Disease • Immunology • Ocular Infections • Ocular Inflammation • Ophthalmology • IL13

BG07 Usage of dupilumab treatment in generalized bullous pemphigoid in two older Asian patients with favourable outcomes. (PubMed, Br J Dermatol) - "He developed gastritis after initially taking oral prednisolone 20 mg per day. Both patients of East Asian descent responded favourably to the treatment and were able to achieve remission within 8 weeks, which reflected a satisfactory outcome from dupilumab treatment, especially with the absence of adverse events. As a result, dupilumab could be a welcome option in treatment of BP, especially as the typical patient with BP is older and may have multiple existing comorbidities or a preexisting immunocompromised state."

Journal • Bullous Pemphigoid • Cardiovascular • CNS Disorders • Congestive Heart Failure • Dermatology • Dermatopathology • Gastrointestinal Disorder • Heart Failure • Immunology • Movement Disorders • Osteoporosis • Parkinson's Disease • Rheumatology • IL13 • IL4R

P113 JAK in the box: unlocking real-world factors influencing Janus kinase inhibitor and dupilumab prescribing in atopic dermatitis. (PubMed, Br J Dermatol) - "A retrospective review was carried out of patients aged ≥ 12 years prescribed dupilumab or a JAKi (upadacitinib, abrocitinib or baricitinib) for AD in our tertiary dermatology centre between 2021 and 2024. Tralokinumab and lebrikizumab were excluded as all patients had prior dupilumab...Factors favouring dupilumab prescribing include older age, asthma status and cardiovascular risk factors. Factors favouring JAKi prescribing included speed of onset, ease of prescribing, younger age and needle phobia."

Journal • Real-world evidence • Retrospective data • Alopecia • Asthma • Atopic Dermatitis • Cardiovascular • Dermatitis • Dermatology • Dyslipidemia • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Hypertension • Immunology • Inflammation • Inflammatory Bowel Disease • Musculoskeletal Diseases • Musculoskeletal Pain • Orthopedics • Pain • Pulmonary Disease • Respiratory Diseases • Thrombosis • STAT2

P102 Raising the bar of efficacy in atopic dermatitis: lebrikizumab provides deep clinical and itch responses up to 16 weeks (ADvantage study). (PubMed, Br J Dermatol) - P3 | "Around 17% of patients had been previously exposed to dupilumab. Lilly has exclusive rights for the development and commercialization of lebrikizumab in the USA and the rest of the world outside of Europe. Medical writing was funded by Almirall S.A."

Clinical • Journal • Atopic Dermatitis • Dermatitis • Dermatology • Immunology • Pruritus • IL13

BH17 Bridging the gap: identifying dual-targeting therapies for patients with alopecia areata and coexisting immune-mediated inflammatory diseases. (PubMed, Br J Dermatol) - "For eczema, therapies such as dupilumab show limited evidence in also treating AA...For instance, baricitinib is licensed for both AD and AA, while upadacitinib is licensed for AD and is currently in phase III trials for AA. Amlitelimab, which targets the OX40 ligand pathway, is currently in phase III clinical trials for atopic dermatitis and in phase II trials for severe AA...In psoriasis, overlapping therapies include ustekinumab, approved for psoriasis and being studied for AA. As for patients with RA, tofacitinib is approved for moderate-to-severe disease and is also utilized in AA. Abatacept is a cytotoxic T lymphocyte-associated protein 4 (CTLA4) immunoglobin costimulatory modulator that attenuates the activation of T cells and is widely used in RA...The Global Registry of Alopecia areata disease Severity and treatment Safety (GRASS) UK is a prospective, multicentre, observational clinical registry designed to create harmonized datasets. These datasets aim to..."

Journal • Review • Alopecia • Atopic Dermatitis • CNS Disorders • Crohn's disease • Dermatitis • Dermatology • Gastroenterology • Genetic Disorders • Immunology • Inflammation • Inflammatory Arthritis • Inflammatory Bowel Disease • Multiple Sclerosis • Psoriasis • Rheumatoid Arthritis • Rheumatology • Vitiligo • CTLA4

P093 Switching patients who developed arthritis and/or enthesitis on dupilumab to tralokinumab: a case series. (PubMed, Br J Dermatol) - "Patient 2 developed bilateral shoulder, left Achilles tendon and back pain 2 years into dupilumab, which resolved when he switched to abrocitinib. To our knowledge, this is the first retrospective case series to report tralokinumab-associated inflammatory arthritis. These cases suggest that patients who develop arthritis or enthesitis on dupilumab are likely to experience similar symptoms on tralokinumab, and a treatment class switch (specifically to a Janus kinase inhibitor) can be beneficial.TablePatient characteristics Patient 1Patient 2Patient 3SexFemaleMaleFemaleAge (years)557028Eczema Area and Severity Index Baseline (pretreatment)23.630.329.5 On tralokinumab (month)6.1 (6)29.6 (4)2.1 (4)Arthropathy pattern Small joints+++ Large joints++-Enthesitis/tenosynovitis+++Ultrasound+N/A+CRP/ESRNormalN/ARaisedConcurrent managementNSAIDsN/ANSAIDsDuration of tralokinumab (months)13724Musculoskeletal symptom progressionImprovingResolvedImprovingTherapy after..."

Journal • Atopic Dermatitis • Back Pain • Dermatitis • Dermatology • Immunology • Inflammation • Inflammatory Arthritis • Musculoskeletal Diseases • Musculoskeletal Pain • Orthopedics • Pain • Rheumatology • CRP • IL13

PA28 Cutaneous sarcoidosis mimicking molluscum contagiosum. (PubMed, Br J Dermatol) - "In July 2023, dupilumab was commenced by the respiratory team for her severe asthma and it had a beneficial effect on her eczema...Lymecycline 408 mg once daily for 2 months and mometasone furoate 0.1% ointment were commenced but the disease continued to progress. We then commenced doxycycline 100 mg daily alongside mometasone furoate 0.1% ointment due to the patient's strong desire to avoid blood tests...Although it is an uncommon presentation, it is important to be aware of it as a differential diagnosis in cases of atypical molluscum contagiosum. This case, in addition to its severity and rarity, has proven challenging to manage given the patient's severe venepuncture phobia."

Journal • Asthma • Atopic Dermatitis • Dermatitis • Dermatology • Immunology • Ophthalmology • Pediatrics • Pulmonary Disease • Respiratory Diseases • Sarcoidosis

P117 Treatment and investigation of head and neck dermatitis in patients with atopic dermatitis treated with biologic and small-molecule therapies: a systematic review. (PubMed, Br J Dermatol) - "Improved/resolved HND was not reported per patient, but in one trial, the median time to 75% improvement in HND was 57 days for dupilumab (n = 238) vs. 29 days for abrocitinib 200 mg...Adverse HND was also reported for tralokinumab (3 of 49, 6%) and baricitinib (two of three, 67%)...Itraconazole led to clinical improvement in all cases that recurred on withdrawal...Future studies should compare head and neck outcomes between different biologics and JAKis. This will help improve treatment decisions for patients where HND is of particular concern."

Journal • Review • Atopic Dermatitis • Dermatitis • Dermatology • Immunology

P015 Clinical characteristics of patients and treatment of moderate-to-severe chronic hand eczema in the UK: the RWEAL study. (PubMed, Br J Dermatol) - "Among 183 patients treated by dermatologists, 11% received alitretinoin, 10% phototherapy, 10% methotrexate, 8% ciclosporin and 7% dupilumab during the past 12-month period. This indicates a need for new treatment options that address the heterogeneous and multifactorial nature of CHE. The absence of clear lines of treatment after TCS suggests a need for UK-specific guidelines for CHE."

Journal • Retrospective data • Atopic Dermatitis • Contact Dermatitis • Dermatitis • Dermatology • Immunology • Pruritus

BI35 A case of dupilumab-induced scalp psoriasis and review of the literature. (PubMed, Br J Dermatol) - "The AD was ineffectively controlled by topical steroids, ultraviolet therapy and abrocitinib. He was trialled on methotrexate (up to 12.5 mg per week), which helped control his eczema but was discontinued because of deranged liver function. He continued to develop severe recurrent flare-ups requiring treatment with short-term oral prednisolone and then ciclosporin...His AD is being managed with lebrikizumab...Hypothetically, the blockade of the T helper (Th)2 response with dupilumab by targeting the IL-4/IL-13 signalling pathway could result in a shift towards a Th1/Th17 phenotype, leading to an inflammatory cytokine cascade and eventually psoriatic skin plaques, as described in this report. Dermatologists should be aware of psoriasis as a potential adverse event with dupilumab."

Journal • Review • Allergic Rhinitis • Alopecia • Asthma • Atopic Dermatitis • Dermatitis • Dermatology • Immunology • Inflammation • Mood Disorders • Psoriasis • Psychiatry • Pulmonary Disease • Respiratory Diseases • IL13 • IL4

PA31 The role of the dermatologist in identifying inborn errors of immunity in patients presenting with atopic dermatitis. (PubMed, Br J Dermatol) - "The patient was started on immunoglobulin infusions and dupilumab, with some improvement in his eczematous rash, before receiving a 100% matched unrelated-donor haematopoietic stem cell transplantation (HSCT)...However, the molecular link between DOCK8 deficiency and atopic skin inflammation remains unknown. This case highlights the importance of considering inborn errors of immunity in such cases of severe eczema associated with apparent immune dysregulation and susceptibility to recurrent infections."

Journal • Allergy • Asthma • Atopic Dermatitis • Bone Marrow Transplantation • Dermatitis • Dermatology • Food Hypersensitivity • Hematological Disorders • Herpes Simplex • Herpes Zoster • Immunology • Infectious Disease • Inflammation • Oncology • Otorhinolaryngology • Primary Immunodeficiency • Pulmonary Disease • Respiratory Diseases • Transplantation • Varicella Zoster • DOCK8

BI29 Treatment-associated anaemia on Janus kinase inhibitors for atopic dermatitis: a case report, review of the literature and discussion of treatment. (PubMed, Br J Dermatol) - "We treated a 74-year-old woman with lifelong AD, refractory to multiple systemic treatments including ciclosporin, methotrexate, mycophenolate mofetil and dupilumab, with upadacitinib 30 mg daily...Haematology recommended initiation of darbepoetin alfa at 150 μg weekly...No articles in the dermatology, rheumatology or gastroenterology literature offer advice on managing JAK inhibitor-associated anaemia, nor did we find information on restarting JAK inhibitors after resolution of anaemia outside the haematology literature. However, JAK inhibitors can safely be restarted after resolution of anaemia, which is important information in management of this complication and providing patient care."

Journal • Review • Anemia • Atopic Dermatitis • Crohn's disease • Dermatitis • Dermatology • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Immunology • Inflammation • Inflammatory Bowel Disease • Monoclonal Gammopathy • Pulmonary Disease • Rheumatology • JAK1 • JAK2

PA02 Dupilumab-induced eosinophilia in paediatric patients with eczema: pointers for dermatologists. (PubMed, Br J Dermatol) - "The majority of patients can be managed through their skin flares with topical treatments and oral corticosteroids if required. To address this need, we propose a standardized guideline for dermatologists to ensure safe and effective use of dupilumab in paediatric dermatology."

Journal • Retrospective data • Allergic Rhinitis • Allergy • Asthma • Atopic Dermatitis • Dermatitis • Dermatology • Eosinophilia • Food Hypersensitivity • Hypereosinophilic Syndrome • Immunology • Pediatrics • Primary Immunodeficiency • Prurigo Nodularis • Pulmonary Disease • Renal Disease • Respiratory Diseases • IL13 • IL4

BI27 Treatment of recalcitrant eczema in a patient with B-cell and natural killer cell lymphopenia of unknown cause. (PubMed, Br J Dermatol) - "He had tried superpotent topical corticosteroids and oral prednisolone, as well as emollients, none of which had improved his symptoms...Tralokinumab was trialled for 12 weeks, as this has a single therapeutic target (interleukin-13), but unfortunately there was no improvement. Following discussion with the immunologists, he was commenced on upadacitinib as this was felt to have a more targeted immunosuppressive effect above agents such as methotrexate and dupilumab. We await his next follow-up appointment to assess response. This case highlights the complexity of treating an immunocompromised individual with immunosuppressive agents, when the cause of their immunosuppression is unknown."

Journal • Atopic Dermatitis • Cutaneous T-cell Lymphoma • Dermatitis • Dermatology • Herpes Zoster • Immunology • Infectious Disease • Mycosis Fungoides • Oncology • Solid Tumor • Thymoma • Thymus Cancer • Varicella Zoster • BTK • GATA2 • IL13

PA08 The use of dupilumab for complex dermatoses: a case series. (PubMed, Br J Dermatol) - "Her medications included azathioprine and tacrolimus...Both had comorbid mitochondrial disease requiring heart transplantation for dilated cardiomyopathy, and immunosuppression with ciclosporin...Despite the complexity of each described case, with comorbid immunodeficiency, failure of other systemic medications and atypical indications, dupilumab worked well without harm or multidisciplinary team objection. It should be considered as a relatively safe and efficacious option in complex cases such as these."

Journal • Atopic Dermatitis • Cardiomyopathy • Cardiovascular • Dermatitis • Dermatology • Immunology • Metabolic Disorders • Pain • Transplantation • Vitiligo • CARD11 • IL4

PD04 Shining a light on eczema: a prospective, comparative, cohort study of dupilumab and Janus kinase inhibitors in photosensitive atopic dermatitis. (PubMed, Br J Dermatol) - "While dupilumab effectively reduces flare intensity and itch severity, its effect on photosensitivity is minimal. These results highlight the need for larger studies to further validate these findings and refine PSAD treatment strategies."

Clinical • Journal • Atopic Dermatitis • Dermatitis • Dermatology • Immunology • IL13 • IL4

BG08 Drug-induced colitis secondary to dupilumab prescribed for pompholyx eczema-bullous pemphigoid overlap: a case report. (PubMed, Br J Dermatol) - "Improvement in bowel symptoms necessitated withdrawal of dupilumab and commencement of infliximab 5 mg kg-1. They have remained well controlled 18 months later. This case report describes a rare occurrence of drug-induced colitis secondary to dupilumab and highlights the need for careful observation for adverse effects and prompt intervention."

Journal • Atopic Dermatitis • Bullous Pemphigoid • Dermatitis • Dermatology • Dermatopathology • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • Ulcerative Colitis • IL13 • IL4

PA12 Evaluating how we manage our paediatric patients with eczema and psoriasis with systemic agents, and identifying barriers to research registry recruitment. (PubMed, Br J Dermatol) - "We identified 42 paediatric patients treated with a systemic for their eczema (n = 34) or psoriasis (n = 8), which included methotrexate (n = 20), dupilumab (n = 18), adalimumab (n = 3) and ustekinumab (n = 1). Failure to inform patients about research registries has also been identified as a barrier to enrolment, with feedback from patient guardian interviews overwhelmingly positive regarding willingness to enrol. Increased education and promotion of these registries is clearly paramount to increasing recruitment."

Journal • Retrospective data • Atopic Dermatitis • Dermatology • Immunology • Pediatrics • Psoriasis

P047 Successful treatment with dupilumab in patients with bullous pemphigoid and concomitant atopy. (PubMed, Br J Dermatol) - "Together, the results suggest that IL-4/IL-13 signalling seems to be clinically important in the pathogenesis of BP, and may represent a promising target for BP therapy. As patients with BP are often older and present several comorbidities, dupilumab might be a promising treatment option with few side-effects."

Journal • Atopic Dermatitis • Bullous Pemphigoid • Dermatitis • Dermatology • Dermatopathology • Immunology • Inflammation • Pruritus • IL13 • IL4

PA24 Evaluating the efficacy and safety of systemic immunomodulatory therapies in paediatric atopic dermatitis: a comprehensive critical review. (PubMed, Br J Dermatol) - "Among the immunosuppressive agents, ciclosporin emerged as the first-line treatment for short-term use, followed by methotrexate. More recent studies also indicate that dupilumab demonstrates promising efficacy and safety in the treatment of childhood AD...While systemic therapies for paediatric AD have demonstrated varying degrees of effectiveness, there remains a lack of robust evidence supporting long-term treatment options and head-to-head comparisons of these agents. High-quality trials with rigorous methodologies are needed to provide stronger evidence and facilitate the development of international guidelines for the optimal management of paediatric AD."

Journal • Review • Atopic Dermatitis • Dermatitis • Dermatology • Immunology • Infectious Disease • Inflammation • Pediatrics • Pruritus

BI36 A case study of hypereosinophilic syndrome in a patient with atopic dermatitis on dupilumab therapy and Strongyloides infection. (PubMed, Br J Dermatol) - "Despite topical treatments and ciclosporin, his eczema persisted, leading to the initiation of dupilumab...This is a case of hypereosinophilic syndrome with colitis secondary to dupilumab in a patient with positive Strongyloides serology. This case demonstrates the diagnostic difficulty in Strongyloides-positive patients, given that both hypereosinophilic syndrome and Strongyloides hyperinfection can present with colitis, and there is a theoretical risk of disseminated Strongyloides and hyperinfection in patients immunosuppressed with dupilumab."

Journal • Asthma • Atopic Dermatitis • Dermatitis • Dermatology • Eosinophilia • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Hematological Malignancies • Hypereosinophilic Syndrome • Immunology • Infectious Disease • Metabolic Disorders • Oncology • Pain • Pulmonary Disease • Respiratory Diseases