Dupilumab and Vaccine Administration

Dupilumab inhibits interleukin (IL)-4 and IL-13 signalling. This monoclonal antibody also acts as an immunomodulator. The current recommendation is to avoid live vaccine administration in dupilumab-treated patients.

A case series involving nine children with severe atopic dermatitis (AD) receiving measles, mumps, and rubella (MMR) vaccine with/without the varicella vaccine in dupilumab clinical trials found no emergence of side effects within four weeks after vaccination. Consequently, the researchers concluded that dupilumab is safe to continue during vaccine administration. This case report is published in Pediatric Dermatology.

In a phase 2/3 clinical trial of dupilumab involving 6-month to 5-year-old children (subsequently participated in the LIBERTY AD PED-OLE) with moderate-to-severe atopic dermatitis, nine children (protocol deviation) received MMR vaccine with or without varicella vaccine. Five of these children received the vaccine with a ≤12-week gap after dupilumab administration, while four received it >12 weeks after discontinuing dupilumab.

Key Findings from the Study

• Nine children had severe AD at baseline.
• Five of the nine children received the MMR or MMR and varicella vaccines within a 1-7 week gap after their dupilumab administration, with treatment resuming for one child as early as two days and three children after 18-43 days.
• No serious adverse events were reported during a post-vaccination period in any children.

Concluding further, they said, in this case, a series of nine children with severe AD who received the MMR vaccine with or without varicella vaccine while being treated with dupilumab, no adverse events or infection were reported within four weeks of vaccination. Further studies are needed to investigate safety and immune response to live attenuated vaccines in dupilumab-treated patients.

Sanofi and Regeneron Pharmaceuticals Inc. the study.

Reference

Siegfried et al. A case series of live attenuated vaccine administration in dupilumab‐treated children with atopic dermatitis. Pediatric Dermatology.