Arthritis induced by dupilumab treatment: A case report and literature review

Dupilumab is a human monoclonal IgG4 antibody targeting the interleukin-4 receptor alpha chain (IL-4Rα). It effectively inhibits the signaling pathways of both interleukin-4 (IL-4) and interleukin-13 (IL-13) and has been extensively employed in managing conditions such as atopic dermatitis, asthma, allergic rhinitis, and other allergic disorders. Despite numerous studies affirming its safety profile, suppression of IL-4 and IL-13 has been linked to an increased dominance of interleukin-17 (IL-17), which can lead to adverse effects resembling those seen in psoriatic arthritis and spondyloarthropathy-like symptoms. Through a case study of a patient receiving dupilumab for prurigo nodularis, this paper seeks to shed light on the potential inflammatory disease-like side effects associated with this treatment. Specifically, we explore manifestations such as enthesitis/arthritis, psoriasis, uveitis, inflammatory bowel disease, lupus erythematosus, and vasculitis, urging vigilance among rheumatologists and dermatologists.