Live Vaccines Safe for Patients on Dupilumab

FRIDAY, June 14, 2024 — A recent position paper published on June 5 in the Annals of Allergy, Asthma & Immunology provides comprehensive insights into the safety and efficacy of administering live vaccines to patients undergoing treatment with dupilumab. The paper indicates that there is no evidence suggesting that such vaccinations pose any safety risks or that dupilumab affects the efficacy of these vaccines.

Dupilumab is known to target the interleukin (IL)-4 receptor alpha subunit, thereby inhibiting the effects of both IL-4 and IL-13. During clinical trials, patients were not permitted to receive live vaccines due to concerns over its immune modulatory effects. This precaution led Jay A. Lieberman, M.D., from The University of Tennessee Health Science Center in Memphis, along with his colleagues, to conduct a systematic review of existing literature. Their objective was to evaluate both the safety and efficacy of vaccines in patients treated with dupilumab and to offer expert advice on the subject.

The review concluded that live vaccines are generally safe for patients on dupilumab, as evidenced by the literature available. Additionally, the efficacy of vaccines does not seem to be compromised by dupilumab. The consensus among the researchers is that the use of vaccines in these patients is both safe and effective.

However, the authors noted a lack of large-scale, robust studies that could provide a narrow confidence interval to conclusively demonstrate safety. They emphasized that such studies are unlikely to be conducted or funded, which poses a challenge to changing the current recommendations by regulatory agencies regarding live vaccinations for patients on dupilumab.

Several authors of the paper have disclosed connections to Sanofi and Regeneron, the companies that produce dupilumab.