Successful treatment with dupilumab in mepolizumab-resistant allergic bronchopulmonary aspergillosis

• Published in: Respiratory medicine case reports Vol. 47; p. 101964
• Main Authors: Kawasaki, Yasutaka, Nishiki, Kazuaki, Ishizaki, Takeshi
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-01-2024; Elsevier
• Subjects: Allergic bronchopulmonary aspergillosis; Asthma; Case Report; Dupilumab; Mepolizumab; Prednisolone; Allergic bronchopulmonary aspergillosis; Mepolizumab; Dupilumab; Prednisolone; Asthma
• ISSN: 2213-0071; 2213-0071
• DOI: 10.1016/j.rmcr.2023.101964

A 67-year-old woman with a history of poorly controlled asthma was admitted to our hospital with a persistent cough and abnormal chest radiographic findings. Her diagnosis was allergic bronchopulmonary aspergillosis (ABPA). Following treatment with mepolizumab, her symptoms and imaging findings improved initially. However, after approximately 2 years, the patient experienced a recurrent cough with elevated non-specific immunoglobulin E levels and worsening chest imaging findings, thereby changing her diagnosis to recurrent ABPA. Mepolizumab was substituted with dupilumab, and her subjective symptoms and imaging findings improved. Our findings suggest that dupilumab may be effective in ABPA cases following the failure of another antibody therapy.
•Humanized monoclonal antibodies are effective in patients with ABPA and may serve as a viable substitute for prednisolone.•Humanized monoclonal antibodies exhibit initial efficacy against ABPA; however, their effectiveness may attenuate over time.•Dupilumab may be effective in ABPA cases following the failure of another antibody therapy.