Biological drugs in the therapy of atopic dermatitis and bronchial asthma: focus on dupilumab

Cover Page

Cite item


Significant progress has been made over the past decade in the treatment of allergic diseases such as atopic dermatitis and bronchial asthma. Dupilumab, which targets interleukin IL-4 and IL-13, has become an innovative targeted therapy. Immunobiologic therapy with the interleukin inhibitor is indicated for patients with moderate to severe uncontrolled atopic dermatitis, moderate to severe eosinophilic phenotype of uncontrolled Bronchial asthma and patients with poorly controlled severe chronic polyposis rhinosinusitis. A clinical case and recent data on the use of dupilumab for the treatment of type 2 inflammatory disease and prospects for its use are discussed.

Full Text

Restricted Access

About the authors

Vera A. Reviakina

Federal Research Center for Nutrition and Biotechnology

ORCID iD: 0000-0002-1149-7927

D. Sci. (Med.), Prof., Federal Research Center for Nutrition and Biotechnology

Russian Federation, Moscow

Natalia A. Geppe

Sechenov First Moscow State Medical University (Sechenov University)

ORCID iD: 0000-0003-0547-3686

D. Sci. (Med.), Prof., Sechenov First Moscow State Medical University (Sechenov University)

Russian Federation, Moscow

Aleksandr B. Malakhov

Sechenov First Moscow State Medical University (Sechenov University); Morozov Children's City Clinical Hospital

ORCID iD: 0000-0002-2686-8284

D. Sci. (Med.), Prof., Sechenov First Moscow State Medical University (Sechenov University), Morozov Children's City Clinical Hospital

Russian Federation, Moscow; Moscow

Oleg V. Kaliuzhin

Sechenov First Moscow State Medical University (Sechenov University)

ORCID iD: 0000-0003-3628-2436

D. Sci. (Med.), Prof., Sechenov First Moscow State Medical University (Sechenov University)

Russian Federation, Moscow

Natalia G. Astaf'eva

Razumovsky Saratov State Medical University

ORCID iD: 0000-0002-7691-4584

D. Sci. (Med.), Prof., Razumovsky Saratov State Medical University

Russian Federation, Saratov

Natalia G. Kolosova

Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
ORCID iD: 0000-0001-5071-9302

Cand. Sci. (Med.), Sechenov First Moscow State Medical University (Sechenov University)

Russian Federation, Moscow

Mariia A. Malakhova-Kapanadze

Kolomna Central District Hospital


Deputy Chief doctor, Kolomna Central District Hospital

Russian Federation, Kolomna


  1. Pefoyo AJ, Bronskill SE, Gruneir A, et al. The increasing burden and complexity of multimorbidity. BMC Public Health. 2015;15:415. doi: 10.1186/s12889-015-1733-2. PMID: 25903064. PMCID: PMC4415224.
  2. Brunner PM, Silverberg JI, Guttman-Yassky E, et al. Councilors of the International Eczema Council. Increasing Comorbidities Suggest that Atopic Dermatitis Is a Systemic Disorder. J Invest Dermatol. 2017;137(1):18-25. doi: 10.1016/j.jid.2016.08.022. PMID: 27771048.
  3. Harrison C, Fortin M, van den Akker M, et al. Comorbidity versus multimorbidity: Why it matters. J Comorb. 2021;11:2633556521993993. doi: 10.1177/2633556521993993. PMID: 33718251. PMCID: PMC7930649.
  4. Gandhi NA, Bennett BL, Graham NM, et al. Targeting key proximal drivers of type 2 inflammation in disease. Nat Rev Drug Discov. 2016;15(1):35-50. doi: 10.1038/nrd4624. PMID: 26471366.
  5. Palomares O, Akdis M, Martín-Fontecha M, Akdis CA. Mechanisms of immune regulation in allergic diseases: the role of regulatory T and B cells. Immunol Rev. 2017;278(1):219-36. doi: 10.1111/imr.12555. PMID: 28658547.
  6. Stone KD, Prussin C, Metcalfe DD. IgE, mast cells, basophils, and eosinophils. J Allergy Clin Immunol. 2010;125(2 Suppl. 2):S73-80. doi: 10.1016/j.jaci.2009.11.017. PMID: 20176269. PMCID: PMC2847274.
  7. Burleson SCM, Fick RB, Mannie MD, et al. The Immune Basis of Allergic Lung Disease, Ed.: Richard A. Parent, Comparative Biology of the Normal Lung (Second Edition), Academic Press, 2015; p. 683-719.
  8. Abdelaziz MH, Abdelwahab SF, Wan J, et al. Alternatively activated macrophages; a double-edged sword in allergic asthma. J Transl Med. 2020;18(1):58. doi: 10.1186/s12967-020-02251-w. PMID: 32024540. PMCID: PMC7003359.
  9. Zhu L, Ciaccio CE, Casale TB. Potential new targets for drug development in severe asthma. World Allergy Organ J. 2018;11(1):30. doi: 10.1186/s40413-018-0208-1. PMID: 30386455. PMCID: PMC6203275.
  10. Атопический дерматит. Клинические рекомендации. Общероссийская общественная организация «Российское общество дерматовенерологов и косметологов», Общероссийская общественная организация «Российская ассоциация аллергологов и клинических иммунологов», Общероссийская общественная организация «Союз педиатров России». 2020. Режим доступа: Ссылка активна на 15.06.2021 [Atopic dermatitis. Clinical guidelines. All-Russian public organization “Russian Society of Dermatovenereologists and Cosmetologists”, All-Russian Public Organization “Russian Association of Allergists and Clinical Immunologists”, All-Russian Public Organization “Union of Pediatricians of Russia”. Available at: Accessed: 15.06.2021 (in Russian)].
  11. Harmonising Outcome Measures for Eczema (HOME). Available at: Accessed: 15.06.2021.
  12. Бронхиальная астма. Клинические рекомендации. Режим доступа: Ссылка активна на 15.06.2021 [Bronchial asthma. Clinical guidelines. Available at: Accessed: 15.06.2021 (in Russian)].
  13. Hynes GM, Hinks TSC. The role of interleukin-17 in asthma: a protective response? ERJ Open Res. 2020;6(2):00364-2019. doi: 10.1183/23120541.00364-2019. PMID: 32494573. PMCID: PMC7248344.
  14. Halwani R, Al-Muhsen S, Al-Jahdali H, Hamid Q. Role of transforming growth factor-β in airway remodeling in asthma. Am J Respir Cell Mol Biol. 2011;44(2):127-33. doi: 10.1165/rcmb.2010-0027TR. PMID: 20525803.
  15. Hauber H-P, Hamid Q. The Role of Interleukin-9 in Asthma. Allergol Int. 2005;54(Issue 1):71-8. doi: 10.2332/allergolint.54.71
  16. Galli SJ, Tsai M. IgE and mast cells in allergic disease. Nat Med. 2012;18(5):693-704. doi: 10.1038/nm.2755. PMID: 22561833; PMCID: PMC3597223.
  17. Furtado PR, Maciel ÁCC, Barbosa RRT, et al. Association between quality of life, severity of asthma, sleep disorders and exercise capacity in children with asthma: a cross-sectional study. Braz J Phys Ther. 2019;23(1):12-8. doi: 10.1016/j.bjpt.2018.08.010. PMID: 30166089. PMCID: PMC6546840.
  18. Global Initiative for Asthma (GINA) 2021. Available at: Accessed: 15.06.2021.
  19. Castro M, Corren J, Pavord ID, et al. Dupilumab Efficacy and Safety in Moderate-to-Severe Uncontrolled Asthma. N Engl J Med. 2018;378(26):2486-96. doi: 10.1056/NEJMoa1804092. PMID: 29782217.
  20. Simpson EL, Paller AS, Siegfried EC, et al. Efficacy and Safety of Dupilumab in Adolescents With Uncontrolled Moderate to Severe Atopic Dermatitis: A Phase 3 Randomized Clinical Trial. JAMA Dermatol. 2020;156(1):44-56. doi: 10.1001/jamadermatol.2019.3336. PMID: 31693077. PMCID: PMC6865265.
  21. Paller AS, Siegfried EC, Thaçi D, et al. Efficacy and safety of dupilumab with concomitant topical corticosteroids in children 6 to 11 years old with severe atopic dermatitis: a randomized, double-blinded, placebo-controlled phase 3 trial. Journal of the American Academy of Dermatology. 2020;83(5):1282-93.
  22. Worm M, Simpson EL, Thaçi D, et al. Efficacy and Safety of Multiple Dupilumab Dose Regimens After Initial Successful Treatment in Patients With Atopic Dermatitis: A Randomized Clinical Trial. JAMA Dermatol. 2020;156(2):131-43. doi: 10.1001/jamadermatol.2019.3617. PMID: 31876900. PMCID: PMC6990756.
  23. Blauvelt A, de Bruin-Weller M, Gooderham M, et al. Long-term management of moderate-to-severe atopic dermatitis with dupilumab and concomitant topical corticosteroids (LIBERTY AD CHRONOS): a 1-year, randomised, double-blinded, placebo-controlled, phase 3 trial. Lancet. 2017;389(10086):2287-303. doi: 10.1016/S0140-6736(17)31191-1. PMID: 28478972.
  24. de Bruin-Weller M, Thaçi D, Smith CH, et al. Dupilumab with concomitant topical corticosteroid treatment in adults with atopic dermatitis with an inadequate response or intolerance to ciclosporin A or when this treatment is medically inadvisable: a placebo-controlled, randomized phase III clinical trial (LIBERTY AD CAFÉ). Br J Dermatol. 2018;178(5):1083-101. doi: 10.1111/bjd.16156. PMID: 29193016.
  25. Ariëns, LFM, van der Schaft, J, Bakker, DS, et al. Dupilumab is very effective in a large cohort of difficult-to-treat adult atopic dermatitis patients: First clinical and biomarker results from the BioDay registry. Allergy. 2020;75:116-26. doi: 10.1111/all.14080
  26. Beck LA, Thaçi D, Deleuran M, et al. Dupilumab Provides Favorable Safety and Sustained Efficacy for up to 3 Years in an Open-Label Study of Adults with Moderate-to-Severe Atopic Dermatitis. Am J Clin Dermatol. 2020;21(4):567-77. doi: 10.1007/s40257-020-00527-x. PMID: 32557382. PMCID: PMC7371647.
  27. NCT03346434. Available at: Accessed: 15.06.2021.
  28. NCT02612454. Available at: Accessed: 15.06.2021.
  29. Available at: Accessed: 15.06.2021.
  30. Available at: Accessed: 15.06.2021.
  31. Cork MJ, Thaçi D, Eichenfield LF, et al. Dupilumab in adolescents with uncontrolled moderate-to-severe atopic dermatitis: results from a phase IIa open-label trial and subsequent phase III open-label extension. Br J Dermatol. 2020;182(1):85-96. doi: 10.1111/bjd.18476. PMID: 31595499. PMCID: PMC6972638.
  32. Rabe KF, Nair P, Brusselle G, et al. Efficacy and Safety of Dupilumab in Glucocorticoid-Dependent Severe Asthma. N Engl J Med. 2018;378(26):2475-85. doi: 10.1056/NEJMoa1804093. PMID: 29782224.
  33. Wenzel S, Castro M, Corren J, et al. Dupilumab efficacy and safety in adults with uncontrolled persistent asthma despite use of medium-to-high-dose inhaled corticosteroids plus a long-acting β2 agonist: a randomised double-blind placebo-controlled pivotal phase 2b dose-ranging trial. Lancet. 2016;388(10039):31-44. doi: 10.1016/S0140-6736(16)30307-5
  34. FDA: Highlights of Prescribing Information (Dupilumab). Available at: Accessed: 15.06.2021.

Supplementary files

Supplementary Files
1. Fig. 1. Global Strategy for asthma management and prevention. Update 2021.

Download (92KB)
2. Fig. 2. The GINA 2021 asthma treatment strategy.

Download (627KB)
3. Fig. 3. Mechanism of dupilumab in type 2 inflammation. (Allergy 2020; 75, 7).

Download (187KB)
4. Fig. 4. Dupilumab reduced annualized rate of servere exacerbations versus placebo in children 6–11 years of age.

Download (100KB)
5. Scheme 1.

Download (49KB)
6. Scheme 2.

Download (46KB)
7. Scheme 3.

Download (51KB)

Copyright (c) 2021 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 74329 от 19.11.2018 г.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies