Please login or create an account. If you do not have access to this content, you will be shown a 30 second preview and licensing options.
- Presentation
The Off-Label Use of Biologics and New Medications: Dupilumab and Apremilast
Description
In this lecture, Jay Wolverton discusses the off-label use of biologic medications, particularly dupilumab and apremilast, focusing on their efficacy and safety in treating various dermatologic conditions. Dupilumab, approved for atopic dermatitis, asthma, and other conditions, has shown efficacy in treating off-label conditions like bullous pemphigoid, chronic spontaneous urticaria, and allergic contact dermatitis, with impressive response rates and minimal adverse effects. Notably, it demonstrated benefits for patients resistant to conventional therapies. Apremilast, another promising medication, has FDA approvals for plaque psoriasis, psoriatic arthritis, and Behçet's disease but shows potential in atopic dermatitis, hidradenitis suppurativa, and vitiligo among other conditions, albeit with mixed results. The lecture highlights that both medications are safe, effective, and often do not require lab monitoring, making them suitable for combination therapy with other medications. More studies are needed to solidify their roles in various dermatologic disorders, but current data points to their potential in enhancing patient outcomes.
View moreConclusions
- Dupilumab is effective for off-label use in various dermatologic conditions with a high safety profile.
- It has shown positive results in treating conditions such as chronic spontaneous urticaria, bullous pemphigoid, allergic contact dermatitis, and hand/foot dermatitis.
- Dupilumab can lead to significant improvement in chronic idiopathic pruritus and alopecia areata, although data is still developing.
- Combination therapies using Dupilumab with other treatments can enhance effectiveness and reduce steroid usage.
- Apremilast also presents a promising off-label option with potential benefits for conditions like hidradenitis suppurativa and vitiligo.
- While Apremilast shows some trends of efficacy in atopic dermatitis, it lacks strong indications in severe cases.
- Apremilast may provide improvement for patients with aphthous stomatitis and lichen planus according to case reports.
- Both Dupilumab and Apremilast have interesting case report uses that warrant further investigation, especially in complex conditions like pyoderma gangrenosum and dermatomyositis.
- Abdat R. JAAD. 2020;83(1):46.
- Bruni M. Dermatol Online J. 2022;28(2):6.
- Klepper E. Dermatol Online J. 2021;27(9):6.
- Yang J. Dermatol Ther. 2022;35:e15648.
- Zhang Y. Front Immunol. 2021;12:4144.
- Maurer, et al. JACI. 2021 Meeting Abstract.
- Machler BC. JAAD. 2019;80(1):280.
- Olbrich H. Biomolecules. 2023;13(4):634.
- Goldminz AM. Derm Ther. 2018;31(6).
- Raffi J. JAAD. 2020;82(1):132.
- Simpson EL. JAAD. 2024; online ahead of print.
- Gael T. JEADV. 2022;36(9):1541.
- Diaz A. JEADV. 2020;34(4):161.
- Nakashima C. Br J Dermatol. 2020;182(2):487.
- Peterson D. JAAD Case Rep. 2022;23:76.
- Luk K. J Drugs Dermatol. 2022;21(2):197-199.
- Tirgan, MH. JEADV. 2022;36(2):e120-122.
- Allanore Y. Ann Rheum Dis. 2020;79(12):1600-1607.
- Min MS. J Drugs Dermatol. 2023;22(12):1220-1222.
- Cohen, SR. J Cutan Med Surg. 2020;24(1):90.
- Charlton D. J Clin Rheum. 2021;29(8S):561.
- Bitar C. JAMA Dermatol. 2022;158(12):1357.
- Mikhaylov D. Arch Dermatol Res. 2019;311:29.
- Liu LY. JAAD. 2017;77:773.
- Bettencourt, M. J Drugs Dermatol. 2016;15(8):1026.
- Skellerud, KH. Trials. 2021;22(1):469.
- Kolios, A. NEJM. 2019;381:1975.
- Pincelli, T. JAAD. 2023;88(2):459.
- Schibler, F. JAAD Case Rep. 2017;3(5):410.