Skin testing and dupilumab
Question:
8/26/2020
I was wondering if dupilumab affects skin prick and intradermal testing and if so, how best to evaluate a patient for allergic rhinitis as well as food allergy.
Answer:
I was unable to find a date in the literature regarding skin testing and the impact that dupilumab may or may not have on this procedure.
I asked Dr. Mitch Grayson to comment as well. "I'm not aware of any data regarding this. Anti-IL4/IL13 does not impair the degranulation of mast cells with allergen challenge, so assessing allergic sensitization by skin testing shouldn't be affected. It is theoretically possible for anti-IL4/IL13 to reduce IgE levels, and this could potentially lead to loss of sensitization. In this scenario, the drug would not lead to a false negative, as the test would be negative because the patient was no longer making IgE against the allergen."
I hope this is helpful,
Andrew Murphy, MD, FAAAAI