The changes of IgE levels in type 2 inflammatory diseases after treatment of dupilumab: a systematic review and meta-analysis

Background Dupilumab is approved for multiple type 2 inflammatory diseases. In the treatment procedure, the changes of IgE levels need further analysis. We evaluated the changes of IgE levels through meta-analysis, aiming to provide a more comprehensive result.Research design and methods Databases were searched to select eligible publications. After being included, study quality was assessed. The standardized mean difference (SMD) was used as an evaluation.Results Seven studies were included. At week 4, the level of IgE did not decrease significantly, with SMD = −0.12 (95%CI: −0.31, 0.07) (P > 0.05). At week 8, 12, 16, 24, and 52, the level of IgE decreased significantly, which was SMD = −0.26 (95%CI: −0.48, −0.03); −0.25 (95%CI: −0.32, −0.18); −0.49 (95%CI: −0.65, −0.33); −0.30 (95%CI: −0.38, −0.22); −0.40 (95%CI: −0.48, −0.32) (P < 0.05). In AD studies, with the increase of IgE levels, due to the decrease in the total dose of dupilumab, the efficacy index showed a decreasing trend.Conclusions Levels of IgE can be significantly decreased in patients with dupilumab treatment. In AD patients, the efficacy was related to total dose; for patients with high IgE levels, efficacy may be better with the dose increased.