Efficacy and Safety of Dupilumab in Immune Checkpoint Inhibitor Induced Bullous Pemphigoid: A Spanish Multicentric Case Series
Year: 2026
Type: article
Study design: Observational Study
Abstract: Immune checkpoint inhibitors (ICIs) have signifi-cantly improved oncologiconcological outcomes. However, ICIs can elicit immune-mediated adverse effects that may require treatment discontinuation and potentially affect cancer prognosis. Bullous pemphigoid (BP) can be induced by ICIs in up to 1 % of treated patients. Conventional treatments for BP (topical and systemic glucocorticoids as well as other classical immunosuppressants) associate substantial toxicities and may impair antitumour responses. Dupilumab, a monoclonal antibody that blocks IL-4/IL-13 signalling, represents a promising alternative, offering effective disease control with an improved safety profile. In this study, we assessed the efficacy and safety of dupilumab for the treatment of ICI-induced BP (ICI-BP) in a real-world multicentre case series of 19 patients, an underreported clinical setting. The median time to ICI-BP development from ICI initiation was 390 days (IQR 295). Overall, 18 patients (94.74%) achieved a clinical response, of whom 16 (84.21%) attained complete remission. Disease stabilization was observed in one1 patient. Among 17 patients receiving systemic corticosteroids prior to dupilumab, 14 (82.35%) discontinued them afterwards. Additionally, 11 patients (61.11 %; n=18) were able to continue or reintroduce ICI after dupilumab initiation. Dupilumab was well tolerated, with 18 patients (94.74%) experiencing no significant adverse events and only one case of suspected psoriasiform toxicity.
Source: Acta Dermato Venereologica
Authors: Cecilia Tejero-García, Francesc Alamon Reig, Xavier Bosch-Amate, Cristina Carrera, Priscila Giavedoni, Inmaculada Gil Faure, Alicia Jiménez Antón, Ander Mayor Ibarguren, Teresa Usero Bárcena, Marcial Álvarez-Salafranca, Marta Gamissans Cañada, Joaquín López Robles, Sandra Martínez-Fernández, Sonia Segura, Dolores Sánchez-Aguilar Rojas, Ángeles Flórez
Institutions: Complejo Hospitalario Universitario de Santiago, Instituto de Investigación Sanitaria de Santiago, Servicio Gallego de Salud, Hospital Clínic de Barcelona, Universitat de Barcelona, Instituto de Salud Carlos III, Centre for Biomedical Network Research on Rare Diseases, Centro de Investigación Biomédica en Red, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Hospital Universitari Sant Joan de Reus, Hospital Universitario Puerta del Mar, Hospital Universitario La Paz, Complejo Hospitalario Universitario de Ferrol, Universidad de Zaragoza, Hospital Universitario Miguel Servet, Bellvitge University Hospital, Hospital General Universitario Morales Meseguer, Complejo Hospitalario de Pontevedra, Hospital Del Mar, Universidade de Santiago de Compostela
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,725
OpenAlex ID: W7161963620