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Complete withdrawal of glucocorticoids after dupilumab therapy in allergic bronchopulmonary aspergillosis: A case report

T. Nishimura, Tomohito Okano, Masahiro Naito, Chikashi Tsuji, Soichi Iwanaka, Yasumasa Sakakura, Taro Yasuma, Hajime Fujimoto, Corina N. D’Alessandro‐Gabazza, Yasuhiro Oomoto, Tetsu Kobayashi, Esteban C. Gabazza, Hidenori Ibata

2021World Journal of Clinical Cases18 citationsDOIOpen Access PDF

Abstract

BACKGROUND: species that aggravates bronchial asthma. Previous studies demonstrated the glucocorticoid-sparing effect of dupilumab in patients with ABPA. There is no report of complete withdrawal of glucocorticoids after dupilumab. CASE SUMMARY: . The diagnosis was ABPA. The patient was treated with oral glucocorticoids from April 2017 to November 2017. In January 2019, she had bronchial asthma exacerbation, and a chest computed tomography scan showed recurrent mucoid impaction. She was treated with oral glucocorticoids and itraconazole. In February 2020, during tapering of oral glucocorticoid, she had the third episode of bronchial asthma exacerbation and a mucoid impaction. The patient was treated with dupilumab in addition to oral glucocorticoid and itraconazole. The clinical response improved, and oral glucocorticoid was discontinued in June 2020. CONCLUSION: This is the first case of ABPA in which complete withdrawal of glucocorticoid was possible after treatment with dupilumab.

Topics & Concepts

MedicineAllergic bronchopulmonary aspergillosisDupilumabAspergillosisDermatologyImmunologyAsthmaAntibodyImmunoglobulin EAntifungal resistance and susceptibilityInterstitial Lung Diseases and Idiopathic Pulmonary FibrosisAsthma and respiratory diseases
Complete withdrawal of glucocorticoids after dupilumab therapy in allergic bronchopulmonary aspergillosis: A case report | Litcius