Exploratory Safety Evaluation of Dupilumab Combined With Subcutaneous Immunotherapy in House Dust Mite-Sensitised Patients With Atopic Dermatitis: A Retrospective Case Series From Northern China.

Abstract

Patients with atopic dermatitis (AD) are frequently sensitised to house dust mites (HDM). While Dupilumab is effective, the role of subcutaneous immunotherapy (SCIT) remains unclear. This study evaluated the safety and clinical outcomes of combined Dupilumab and SCIT in HDM-sensitised AD patients. In this retrospective study, 47 adults with HDM-sensitised AD received concurrent Dupilumab and HDM-SCIT for 48 weeks. Eczema Area and Severity Index (EASI) scores, total and HDM-specific IgE levels were monitored. Safety was assessed by adverse events related to SCIT and Dupilumab. EASI scores improved significantly from baseline (28.4 ± 6.9) to Week 12 (14.8 ± 4.5), Week 24 (12.7 ± 4.3) and Week 48 (5.2 ± 2.8). HDM-specific IgE (d1, d2) and total IgE decreased by Week 48 (p < 0.05). SCIT-related local and systemic reactions declined over time. Dupilumab-related conjunctivitis, head and neck dermatitis, and upper respiratory tract infections were transient and reduced during follow-up. The combination of Dupilumab and SCIT was well tolerated and associated with clinical improvement and IgE reduction in HDM-sensitised AD patients. These findings support further investigation in prospective controlled trials.