Effectiveness of Dupilumab and Omalizumab in Bullous Pemphigoid: A Nationwide Retrospective Cohort Study
Year: 2025
Type: article
Study design: Observational Study
Abstract: Bullous pemphigoid (BP) is the most common autoimmune blistering skin disease worldwide. In the difficult-to-treat BP or if standard therapies are contraindicated, the use of biologics may be also considered although there is no strong evidence supporting their use. This study aimed to investigate clinical and diagnostic findings as well as treatment outcomes among patients diagnosed with BP and undergoing omalizumab or dupilumab in a real-world setting. A multicenter retrospective cohort study was performed across 15 Italian tertiary referral hospital. Medical records of 2435 BP patients were screened, identifying 58 (2.3%) Caucasian patients who met the inclusion criteria. Within this study population, 39 (67.2%) were treated with dupilumab and 19 (32.8%) received omalizumab. Disease control was achieved in 90.6% of dupilumab-treated patients and complete remission on minimal therapy was observed in 71.0%. Omalizumab-treated patients achieved disease control in 77.8% of cases and 64.7% obtained complete remission on minimal therapy. Log-rank test comparing relapse rate between treatment groups was not significant (p = 0.58). Finally, parameter estimates associated with the fixed effect of time were consistently negative, indicating a generally significant (p = < 0.05) decrease in scores over time for patients treated with both biologics. This cohort of patients undergoing dupilumab or omalizumab adds to the existing evidence concerning the effectiveness of biologic agents in BP. Both biologics seem to be promising treatment adjuvants in the management of BP, with dupilumab showing a descriptive trend toward better outcomes.
Source: The Journal of Dermatology
Authors: Gianluca Avallone, Carlo Alberto Maronese, Martina Zussino, Simona Muratori, Silvia Mariel Ferrucci, Pietro Quaglino, Elisabetta Manni, Marco Romanelli, Clara De Simone, Caterina Foti, Luigi Gargiulo, Vincenzo Maione, Piergiacomo Calzavara‐Pinton, Federico Bardazzi, Bianca Maria Piraccini, Emiliano Antiga, Giulia Rech, Riccardo Balestri, Pamela Vezzoli, Paolo Sena, Maria Esposito, Maria Concetta Fargnoli, Davide Termini, Luca Valtellini, Rosanna Rita Satta, Camilla Vassallo, Alessia Provini, Giovanni Di Zenzo, Anna Campanati, Marzia Caproni, Emanuele Cozzani, Simone Ribero, Angelo Valerio Marzano, DUO—DUpilumab and Omalizumab in Bullous Pemphigoid Study Group
Institutions: University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Turin, University of Pisa, Università Cattolica del Sacro Cuore, Agostino Gemelli University Polyclinic, Istituti di Ricovero e Cura a Carattere Scientifico, University of Bari Aldo Moro, Humanitas University, IRCCS Humanitas Research Hospital, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, University of Brescia, IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola, University of Bologna, University of Florence, Ospedale Papa Giovanni XXIII, University of L'Aquila, University of Sassari, Policlinico San Matteo Fondazione, Istituto Dermopatico dell'Immacolata, Marche Polytechnic University, University of Genoa
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,630
OpenAlex ID: W4409483988