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Efficacy and glucocorticoid sparing of dupilumab in IgG4-related disease: a case series and literature review


1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11

 

  1. Department of Internal Medicine, CHU Avicenne AP-HP, Bobigny, France. flora.finet@aphp.fr
  2. Department of Pneumonology, CHU Avicenne AP-HP, Bobigny, France.
  3. Department of Internal Medicine, CHU Avicenne AP-HP, Bobigny, France.
  4. Department of Internal Medicine, CHU de Toulouse, France.
  5. Department of Pneumonology, CHU de Guadeloupe, Pointe à Pitre, France.
  6. Department of Internal Medicine, CHU de Caen Normandie, Caen, France.
  7. Department of Internal Medicine, CHU de Caen Normandie, Caen, France.
  8. Department of Internal Medicine, CHU Grenoble-Alpes, Grenoble, France.
  9. Department of Internal Medicine, CHU de La Timone, Université Aix-Marseille, France.
  10. Department of Internal Medicine, CHU Cochin AP-HP, Paris, France.
  11. Department of Internal Medicine, CHU Avicenne AP-HP, Bobigny, France.

CER18394
Full Papers

purchase article

PMID: 40470558 [PubMed]

Received: 29/11/2024
Accepted : 16/04/2025
In Press: 31/05/2025

Abstract

OBJECTIVES:
IgG4-related disease (IgG4-RD) is a multisystem fibro-inflammatory disorder for which glucocorticoids (GC) represent the initial therapeutic intervention. Second-line treatments are not currently codified. The use of dupilumab, an inhibitor of interleukin (IL)-4 and IL-13 signalling, has recently been described as a potential alternative treatment. The aim of this study was to describe the characteristics of patients IgG4-RD treated with dupilumab and to evaluate its impact on disease control.
METHODS:
We conducted a French multicentre retrospective study based on standardised questionnaires distributed to physicians via professional networks. The patients included had to meet 2019 ACR/EULAR criteria or the comprehensive diagnostic criteria for IgG4-RD, and to have been treated with dupilumab. Efficacy was assessed using the IgG4-Related Disease Responder Index.
RESULTS:
A total of seven patients were included in the study. The rationale for initiating dupilumab was based on the presence of severe asthma, nasosinusal polyps and/or atopic dermatitis. A complete response was observed in three patients, while four patients displayed a partial response. In all cases, GC sparing was achieved. A review of the literature revealed nine out of the ten cases reported where a partial or complete reduction of the disorder was documented, along with GC sparing.
CONCLUSIONS:
These preliminary findings need to be confirmed, but may offer arguments in favour of a possible efficacy of dupilumab in the treatment of IgG4-RD.

DOI: https://doi.org/10.55563/clinexprheumatol/nui493

Rheumatology Article