Loading-Dose Dupilumab May Function as a Prophylactic Agent for Food-Induced Anaphylaxis: A Case and Review of the Literature

Recent advances in targeted therapy using monoclonal antibodies have revolutionized care in many fields, and dupilumab for the treatment of moderate-severe atopic dermatitis is no exception. While on a trial of loading dose dupilumab, a 25-year-old white male with a past medical history significant for anaphylaxis after ingesting peanuts and tree nuts did not experience anaphylaxis after accidentally consuming almonds. Similarly to anti-IgE, the large-scale inhibition of IL-4 and IL-13 signaling to various immune cells involved with type II hypersensitivity reactions using loading dose dupilumab may have played a role in preventing anaphylaxis in this patient. The role of loading dose dupilumab as a potential prophylactic agent against food-induced anaphylaxis could be explored cautiously as a novel way to reduce both morbidity and mortality in patients with these allergies.