Among the new biological therapies for atopic diseases, dupilumab is a fully human monoclonal antibody directed against IL-4Rα, the common chain of interleukin-4 and interleukin-13 receptors. Dupilumab showed clinical improvements in patients with atopic dermatitis, asthma, and chronic rhinosinusitis and is currently under development for other indications. While dupilumab is considered to be well tolerated, a number of recent publications have reported various adverse events. This review aims to summarize the current knowledge about these adverse events, which may help clinicians to improve the follow-up of patients on dupilumab. Injection-site reactions are the most common reported adverse event. However, dupilumab has also been shown to cause ophthalmic complications (e.g., dry eyes, conjunctivitis, blepharitis, keratitis, and ocular pruritus), head and neck dermatitis, onset of psoriatic lesions, progression of cutaneous T-cell lymphoma exacerbation, alopecia areata, hypereosinophilia, and arthritis. Most are managed during dupilumab treatment continuation, but some (e.g., severe conjunctivitis) may result in a discontinuation of treatment. Their molecular origin is unclear and requires further investigations. Among other hypothesis, it has been suggested that T helper (Th)2-mediated pathway inhibition may worsen Th1/Th17-dependent immune responses. An ophthalmological examination for the presence of potential predictive indicators of ophthalmic adverse events is recommended before initiation of dupilumab therapy.

在针对特应性疾病的新生物疗法中，dupilumab 是一种针对 IL-4Rα（白细胞介素 4 和白细胞介素 13 受体的共同链）的全人源单克隆抗体。Dupilumab 在特应性皮炎、哮喘和慢性鼻窦炎患者中显示出临床改善，目前正在开发其他适应症。虽然 dupilumab 被认为具有良好的耐受性，但最近的一些出版物报告了各种不良事件。本综述旨在总结目前对这些不良事件的了解，这可能有助于临床医生改善对 dupilumab 患者的随访。注射部位反应是最常见的不良事件。然而，dupilumab 也被证明会引起眼部并发症（例如，干眼症、结膜炎、睑缘炎、角膜炎和眼部瘙痒），头颈部皮炎、银屑病病变的发作、皮肤 T 细胞淋巴瘤恶化的进展、斑秃、嗜酸性粒细胞增多症和关节炎。大多数在 dupilumab 治疗持续期间进行管理，但有些（例如，严重结膜炎）可能导致治疗中断。它们的分子起源尚不清楚，需要进一步研究。在其他假设中，有人提出 T 辅助 (Th)2 介导的通路抑制可能会恶化 Th1/Th17 依赖性免疫反应。建议在开始 dupilumab 治疗之前进行眼科检查，以确定是否存在眼科不良事件的潜在预测指标。大多数在 dupilumab 治疗持续期间进行管理，但有些（例如，严重结膜炎）可能导致治疗中断。它们的分子起源尚不清楚，需要进一步研究。在其他假设中，有人提出 T 辅助 (Th)2 介导的通路抑制可能会恶化 Th1/Th17 依赖性免疫反应。建议在开始 dupilumab 治疗之前进行眼科检查，以确定是否存在眼科不良事件的潜在预测指标。大多数在 dupilumab 治疗持续期间进行管理，但有些（例如，严重结膜炎）可能导致治疗中断。它们的分子起源尚不清楚，需要进一步研究。在其他假设中，有人提出 T 辅助 (Th)2 介导的通路抑制可能会恶化 Th1/Th17 依赖性免疫反应。建议在开始 dupilumab 治疗之前进行眼科检查，以确定是否存在眼科不良事件的潜在预测指标。有人提出，T 辅助 (Th)2 介导的通路抑制可能会恶化 Th1/Th17 依赖性免疫反应。建议在开始 dupilumab 治疗之前进行眼科检查，以确定是否存在眼科不良事件的潜在预测指标。有人提出，T 辅助 (Th)2 介导的通路抑制可能会恶化 Th1/Th17 依赖性免疫反应。建议在开始 dupilumab 治疗之前进行眼科检查，以确定是否存在眼科不良事件的潜在预测指标。