Dupilumab is a Predominant Treatment for Recalcitrant Bullous Pemphigoid

Abstract

Bullous pemphigoid is occasionally recalcitrant to established medications. Our 72-year-old male patient was treated with
established medications such as systemic corticosteroid (prednisone 1.3_0.7mg/kg), methylprednisolone pulse therapy, 7
doses of monthly intravenous immunoglobulin, cyclosporine. During tapering of prednisone, the disease activity easily flared
up, and many complications such as aspiratory pneumonia, chronic urinary infection, hypoalbuminemia were observed.
Given the patient’s severe disease status and treatment limitations, we introduced dupilumab expecting Th2-suppressive
effect, according to the dosing regimen approved for atopic dermatitis. After 2 months of dupilumab therapy, BPDAI (Bullous
Pemphigoid Disease Area Index) score halved, and after 3 months, he accomplished the clearance of the lesions. A placebo-controlled phase 3 clinical trial of dupilumab for s