Abstract: Objective: To evaluate efficacy and safety of dupilumab in the treatment of bullous pemphigoid (BP). Methods: A retrospective study was conducted among 16 patients with BP treated by dupilumab from February, 2021 to February, 2023. The clinical, laboratory and COVID-19 infection date were analyzed. The severity of skin lesions and itching were evaluated by bullous pemphigoid disease area index (BPDAI) and numerical rating scale (NRS) respectively. Karnofsky score was used to evaluate the functional status of BP patients. Common Terminology Criteria for Adverse Events (CTCAE) was used for adverse events evaluation. Results: A total of 16 BP patients were included in this study. At week 16, 8 (50%) cases achieved disease control, 6 (37.5%) cases achieved complete remission, 2 (12.5%) cases were discontinued due to poor efficacy or adverse reactions. The average score of BPDAI and NRS decreased from 38.38±21.90 and 8.8±0.65 to 8.37±9.45 and 3.2±1.05, with significant differences (Ps＜0.05). Karnofsky score increased from 44.67±23.01 to 79.33±19.82 (P＜0.05). Among the 16 patients, 3 (18.7%) tested positive for COVID-19 and improved after symptomatic or topical treatment, while the rest remained stable. Respiratory failure and granulocytopenia occurred in 1 case (6.25%), systemic sweating in 1 case (6.25%), and local adverse reactions in 2 cases (12.5%). No other adverse events were found. Conclusion: The COVID-19 epidemic has no significant impact on the disease management of BP patients enrolled in this study. Dupilumab is an effective and safe treatment for bullous pemphigoid patients.

Key words: upilumab, bullous pemphigoid, clinical efficacy, safety