Circulating igE levels as a biomarker for therapeutic response to dupilumab among patients with prurigo nodularis
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Presented at: Society for Investigative Dermatology 2025
Date: 2025-05-07 00:00:00
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Summary: Abstract Body: Prurigo nodularis (PN) is a chronic neuroimmune disorder marked by intensely pruritic nodules. Variability in therapeutic response to dupilumab, an IL-4 and IL-13 signaling inhibitor, underscores the need to identify predictive biomarkers. This single-center study evaluated baseline immunoglobulin E (IgE) levels as a potential predictor of treatment response in 15 patients with moderate-to-severe PN treated with dupilumab (2017–2023). Demographics, baseline IgE levels, comorbidities, and pre- and post-treatment Worst Itch Numeric Rating Scale (WI-NRS) scores were analyzed. Patients were grouped based on elevated (>114 IU/mL, n=10) or normal (<114 IU/mL, n=5) baseline IgE levels. The mean baseline IgE levels were significantly higher in the elevated-IgE group (566.3 IU/mL) compared to the normal-IgE group (31.49 IU/mL, p=0.02). Baseline WI-NRS scores were similar between groups (7.7 vs. 9.2, p=0.21), as was treatment duration (7.4 vs. 9.3 months, p=0.34). Common comorbidities included hypertension (60%), anxiety (60%), and obesity (53.3%), with no significant differences between groups. Post-treatment WI-NRS scores were significantly lower in the elevated-IgE group (1.4 vs. 6.0, p=0.004), and a higher proportion of these patients achieved a ≥4-point reduction in WI-NRS (90% vs. 40%, p=0.08). These findings suggest that elevated baseline IgE levels may predict a more favorable dupilumab response in PN, providing a basis for stratifying patients by inflammatory endotypes. Larger prospective studies are needed to validate IgE as a biomarker for tailoring PN management strategies. Anjali D'Amiano<sup>1, 2</sup>, Yagiz M. Akiska<sup>2</sup>, Jack Kollings<sup>1, 2</sup>, Aaron Bao<sup>1, 2</sup>, Vrinda Madan<sup>1, 2</sup>, Emily Ma<sup>2</sup>, Shivani Patel<sup>2</sup>, Shawn Kwatra<sup>2</sup> 1. Dermatology, Johns Hopkins Medicine, Baltimore, MD, United States. 2. University of Maryland Baltimore School of Medicine, Baltimore, MD, United States. Clinical Research: Epidemiology and Observational Research