Spontaneous Resolution of Atopic Dermatitis Incidental to Participation in Benralizumab Clinical Trial for Severe, Uncontrolled Asthma

A Case Report

David N. Pham

Disclosures

J Med Case Reports. 2021;15(103) 

In This Article

Background

Eczema, or atopic dermatitis (AD), is a chronic, pruritic, inflammatory skin condition with a mechanism linked to deficiency of function in the skin barrier.[1,2] Challenge by environmental allergens and pathogenic microbes precipitates a complex and exaggerated pro-inflammatory T cell response that includes interleukin-5 (IL-5) stimulation of eosinophil proliferation, activation, and subsequent overproduction of immunoglobulin E (IgE).[1,2] AD tends to precede or co-occur with other allergic diseases such as food allergies, severe eosinophilic asthma, and allergic rhinitis. It is increasingly understood that the physiologic mechanisms underlying these disorders overlap and may be part of a pathologic cascade.[3]

The potential links between these allergic diseases point to a number of attractive therapeutic targets, including IgE antibodies, IL-5, and eosinophils, which are stimulated through the cell surface receptor, IL-5R.[4–6] Several pharmaceutical agents have been approved or are currently in development that are designed to disrupt the IL-5/IL-5R interaction in eosinophilic asthma, AD, or other allergic diseases.[4] However, it is not yet known whether agents developed against one indication will show efficacy against others within the constellation of atopic diseases.

Here, we report spontaneous resolution of AD in an adolescent patient participating in the phase 3 CALIMA pivotal trial, which evaluated the safety and efficacy of the anti-IL-5R mAb benralizumab as an add-on therapy for patients with severe, uncontrolled asthma and elevated blood eosinophil counts.[7]

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