Dupilumab for Food Allergy Linked to Reduced IgE Levels at 12 Months

A study found that dupilumab was linked to the reduction of specific IgE in foods at 12 and 24 months. The findings were presented as a late-breaker at the 2025 American Academy of Allergy, Asthma, & Immunology (AAAAI) in San Diego from February 28 – March 3, 2025.1

Dupilumab targets and inhibits the signaling of Type 2 cytokines IL-4 and IL-13. Although Type 2 cytokines drive IgE-mediated food allergies, dupilumab is not approved for this indication

Dupilumab is currently approved to treat, atopic dermatitis, eosinophilic esophagitis, and chronic obstructive pulmonary disease (COPD).2,3 It can also prevent asthma symptoms by reducing inflammation but is not approved for a sudden asthma attack.2

Given the involvement of Type 2 cytokines in IgE-mediated food allergy, investigators, led by Emily Lothamer, clinical research intern from Indiana University School of Medicine, aimed to assess whether dupilumab would reduce IgE in patients with comorbid food allergies.

The study included 13 patients currently prescribed dupilumab at Deaconess Clinic Allergy who had an official food allergy diagnosis. All patients had ≥ 2 measured IgE levels before starting dupilumab and 1 measured level > 2 months after dupilumab initiation. Among the 13 patients, there were 77 allergens.

The team calculated the percent decrease in IgE level over time for existing IgE levels up to 84 months after beginning dupilumab. They then examined IgE level reductions at 12 and 24 months.

At 12 months, participants had a 56.9% reduction in IgE levels (P < .001; n = 71). At 24 months, participants had a 73.5% reduction in IgE levels (P < .001; n = 37).

Furthermore, patients who passed oral food challenges had a 69.4% reduction in IgE levels at 12 months (P = .012) and an 81.8% reduction at 24 months (P = .027; n = 6).

“Dupilumab was associated with reduction of specific IgE to foods at 12 and 24 months as well as passed food challenge in this retrospective study,” investigators concluded.

References

1. Lothamer, E, McLaughlin, A, and Koleilat, M. Impact of dupilumab on food-specific IgE levels in food-allergic patients. Journal of Allergy and Clinical Immunology. Vol. 155, Issue 2, AB457. 2025. https://www.jacionline.org/article/S0091-6749(24)02348-0/fulltext

2. Dupilumab Injection. Cleveland Clinic. https://my.clevelandclinic.org/health/drugs/20590-dupilumab-injection. Accessed February 27, 2025.

3. Smith, T. FDA Approves Dupilumab (Dupixent) for Treatment of COPD. HCPLive. September 27, 2024. https://www.hcplive.com/view/fda-approves-dupilumab-dupixent-for-treatment-of-copd. Accessed February 27, 2025.