Systematic review of dupilumab safety and efficacy for treatment of keloid scars.
Dupilumab
IL-13
IL-17
IL-4
Keloid
Th17
Journal
Archives of dermatological research
ISSN: 1432-069X
Titre abrégé: Arch Dermatol Res
Pays: Germany
ID NLM: 8000462
Informations de publication
Date de publication:
23 Aug 2024
23 Aug 2024
Historique:
received:
16
07
2024
accepted:
05
08
2024
revised:
17
07
2024
medline:
23
8
2024
pubmed:
23
8
2024
entrez:
23
8
2024
Statut:
epublish
Résumé
Keloids, characterized by excessive scar formation following dermal inflammation, pose a therapeutic challenge due to high recurrence rates. Radiation therapy, contraindicated in children, can minimize recurrence post-surgical removal. Dupilumab, which inhibits the pro-fibrotic interleukin-4/interleukin-13 axis, may effectively manage keloids when intralesional corticosteroid injections are unsuccessful. It may also prevent recurrence post-surgery in pediatric patients. This systematic review assesses the efficacy and safety of dupilumab for the treatment of keloids. Through a systematic search adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we identified and analyzed outcomes from three case reports and three case series studies, totaling 15 patients. Results indicate variable responses to treatment, including significant improvements, no clinical change, and worsening of keloid symptoms. Additional research is needed to recommend using dupilumab to treat keloids (Grade D). Treatment response variability may be linked to differences in interleukin-4/interleukin-13 activity between active and inactive keloids. Additionally, the unintended promotion of T helper 17 cell differentiation by dupilumab may worsen keloids.
Identifiants
pubmed: 39177869
doi: 10.1007/s00403-024-03277-6
pii: 10.1007/s00403-024-03277-6
doi:
Substances chimiques
dupilumab
420K487FSG
Antibodies, Monoclonal, Humanized
0
Interleukin-4
207137-56-2
Interleukin-13
0
IL4 protein, human
0
IL13 protein, human
0
Types de publication
Systematic Review
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
560Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Liu Y et al (2023) Diagnosis and treatment of Keloid: Method Summary and Effect evaluation. Clin Cosmet Investig Dermatol 16:3775–3783
doi: 10.2147/CCID.S446018
pubmed: 38170138
pmcid: 10759814
Ogawa R (2017) Keloid and hypertrophic scars are the result of chronic inflammation in the reticular dermis. Int J Mol Sci, 18(3)
Jagdeo J, Kerby E, Glass DA 2 (2021) Keloids JAMA Dermatol 157(6):744
doi: 10.1001/jamadermatol.2020.4705
pubmed: 33881453
Bijlard E et al (2017) Burden of Keloid Disease: a cross-sectional health-related quality of Life Assessment. Acta Derm Venereol 97(2):225–229
doi: 10.2340/00015555-2498
pubmed: 27378582
Lu W, Chu H, Zheng X (2021) Effects on quality of life and psychosocial wellbeing in Chinese patients with keloids. Am J Transl Res 13(3):1636–1642
pubmed: 33841685
pmcid: 8014351
Mustoe TA et al (2002) International clinical recommendations on scar management. Plast Reconstr Surg 110(2):560–571
doi: 10.1097/00006534-200208000-00031
pubmed: 12142678
Yin Q et al (2023) Intralesional Corticosteroid Administration in the treatment of keloids: a scoping review on injection methods. Dermatology 239(3):462–477
doi: 10.1159/000529220
pubmed: 36657423
Dhar S, Seth J, Parikh D (2014) Systemic side-effects of topical corticosteroids. Indian J Dermatol 59(5):460–464
doi: 10.4103/0019-5154.139874
pubmed: 25284850
pmcid: 4171913
Fredman R, Tenenhaus M (2013) Cushing’s syndrome after intralesional triamcinolone acetonide: a systematic review of the literature and multinational survey. Burns 39(4):549–557
doi: 10.1016/j.burns.2012.09.020
pubmed: 23092701
Ogawa R (2022) The most current algorithms for the Treatment and Prevention of Hypertrophic Scars and keloids: a 2020 update of the algorithms published 10 years ago. Plast Reconstr Surg 149(1):79e–94e
doi: 10.1097/PRS.0000000000008667
pubmed: 34813576
Ekstein SF et al (2021) Keloids: a review of therapeutic management. Int J Dermatol 60(6):661–671
doi: 10.1111/ijd.15159
pubmed: 32905614
Wong AJS, Song EJ (2021) Dupilumab as an adjuvant treatment for keloid-associated symptoms. JAAD Case Rep 13:73–74
doi: 10.1016/j.jdcr.2021.04.034
pubmed: 34179322
pmcid: 8213974
Min MS et al (2023) Successful treatment of keloids and hypertrophic scars with systemic and Intralesional Dupilumab. J Drugs Dermatol 22(12):1220–1222
doi: 10.36849/JDD.6385
pubmed: 38051859
Ogawa R et al (2009) Is radiation therapy for keloids acceptable? The risk of radiation-induced carcinogenesis. Plast Reconstr Surg 124(4):1196–1201
doi: 10.1097/PRS.0b013e3181b5a3ae
pubmed: 19935303
Nguyen JK et al (2020) The IL-4/IL-13 axis in skin fibrosis and scarring: mechanistic concepts and therapeutic targets. Arch Dermatol Res 312(2):81–92
doi: 10.1007/s00403-019-01972-3
pubmed: 31493000
Muromoto R, Oritani K, Matsuda T (2022) Current understanding of the role of tyrosine kinase 2 signaling in immune responses. World J Biol Chem 13(1):1–14
doi: 10.4331/wjbc.v13.i1.1
pubmed: 35126866
pmcid: 8790287
Yin Q et al (2023) The JAK-STAT pathway in keloid pathogenesis: a systematic review with qualitative synthesis. Exp Dermatol 32(5):588–598
doi: 10.1111/exd.14747
pubmed: 36652549
Diaz A et al (2020) Keloid lesions show increased IL-4/IL-13 signaling and respond to Th2-targeting dupilumab therapy. J Eur Acad Dermatol Venereol 34(4):e161–e164
doi: 10.1111/jdv.16097
pubmed: 31747457
US Food and Drug Administration. Highlights of Prescribing Information: DUPIXENT
Wittmer A, Finklea L, Joseph J (2023) Effects of dupilumab on keloid stabilization and prevention. JAAD Case Rep 37:103–105
doi: 10.1016/j.jdcr.2023.05.001
pubmed: 37360650
pmcid: 10285468
Phillips B, Ball C, Sackett D, Badenoch D, Straus S, Haynes B, Dawes M (2009) Oxford Centre for Evidence-Based Medicine: Levels of Evidence. [cited 2024 March 3rd, 2024]; https://www.cebm.ox.ac.uk/resources/levels-of-evidence/oxford-centre-for-evidence-based-medicine-levels-of-evidence-march-2009
Tirgan MH, Uitto J (2022) Lack of efficacy of dupilumab in the treatment of keloid disorder. J Eur Acad Dermatol Venereol 36(2):e120–e122
doi: 10.1111/jdv.17669
pubmed: 34537977
Luk K, Fakhoury J, Ozog D (2022) Nonresponse and progression of diffuse keloids to Dupilumab Therapy. J Drugs Dermatol 21(2):197–199
doi: 10.36849/JDD.6252
pubmed: 35133105
Lee CC et al (2023) An updated review of the immunological mechanisms of keloid scars. Front Immunol 14:1117630
doi: 10.3389/fimmu.2023.1117630
pubmed: 37033989
pmcid: 10075205
Cooney LA et al (2011) Sensitivity and resistance to regulation by IL-4 during Th17 maturation. J Immunol 187(9):4440–4450
doi: 10.4049/jimmunol.1002860
pubmed: 21949021
Lee SY et al (2022) IL-17 induces Autophagy Dysfunction to promote inflammatory cell death and fibrosis in keloid fibroblasts via the STAT3 and HIF-1α Dependent Signaling pathways. Front Immunol 13:888719
doi: 10.3389/fimmu.2022.888719
pubmed: 35757697
pmcid: 9226909
Lee YI et al (2022) WNT5A drives interleukin-6-dependent epithelial-mesenchymal transition via the JAK/STAT pathway in keloid pathogenesis. Burns Trauma 10:tkac023
doi: 10.1093/burnst/tkac023
pubmed: 36225328
pmcid: 9547497
Zhang Q et al (2009) Tumor-like stem cells derived from human keloid are governed by the inflammatory niche driven by IL-17/IL-6 axis. PLoS ONE 4(11):e7798
doi: 10.1371/journal.pone.0007798
pubmed: 19907660
pmcid: 2771422
Bridgewood C et al (2022) Helper 2 IL-4/IL-13 dual blockade with Dupilumab is linked to some Emergent T Helper 17–Type diseases, including Seronegative Arthritis and Enthesitis/Enthesopathy, but not to Humoral Autoimmune diseases. J Invest Dermatol 142(10):2660–2667
doi: 10.1016/j.jid.2022.03.013
pubmed: 35395222