Dupilumab in Type 2 Inflammatory Diseases: Current Evidence and Emerging Therapeutic Applications – A Narrative Review
DOI:
https://doi.org/10.12775/JEHS.2026.95.76627Keywords
dupilumab, IL-4, IL-13, IL-4Rα, type 2 inflammation, atopic dermatitis, asthma, eosinophilic esophagitis, chronic rhinosinusitis with nasal polyps, biologic therapyAbstract
Background.
Dupilumab is a fully human monoclonal antibody targeting the interleukin-4 receptor alpha (IL-4Rα), thereby inhibiting signaling mediated by interleukin-4 (IL-4) and interleukin-13 (IL-13). Since the initial approval for moderate-to-severe atopic dermatitis, its therapeutic indications have expanded substantially and currently include several diseases characterized by type 2 inflammation.
Aim.
The aim of this narrative review was to summarize the current evidence regarding the mechanism of action, established clinical applications, efficacy, safety, and emerging therapeutic indications of dupilumab.
Material and methods.
A narrative literature review was performed using PubMed/MEDLINE, Web of Science, supplemented by clinical guidelines and regulatory documents from the U.S. Food and Drug Administration and European regulatory authorities published between 2017 and 2026.
Results.
Dupilumab has demonstrated clinically relevant efficacy in wide range of dieseases including atopic dermatitis, asthma, chronic rhinosinusitis with nasal polyps, eosinophilic esophagitis, prurigo nodularis. eosinophilic chronic obstructive pulmonary disease, chronic spontaneous urticaria, bullous pemphigoid, and allergic fungal rhinosinusitis. Inhibition of IL-4Rα results in attenuation of type 2 inflammatory signaling, although the clinical treatment response vary between diseases.
Conclusions.
Dupilumab has evolved into a broadly applicable biologic targeting a shared immunological pathway across multiple inflammatory diseases. Its expanding indications emphasize the clinical importance of type 2 inflammation as a therapeutic target. Further studies are required to define optimal patient selection, long-term effectiveness, treatment duration, biomarkers of response, and the role of dupilumab in combination or sequencing with other targeted therapies.
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