When hypereosinophilia occurs during dupilumab therapy: evidence-based strategies for clinical management in respiratory indications
Bibliographic record
Abstract
INTRODUCTION: Dupilumab is a monoclonal antibody which selectively targets T2 inflammation by binding the IL-4 and 13 receptor and blocking its contribution to the immune activation. Clinical trials and real-life studies on severe asthma and nasal polyps patients have reported blood eosinophils fluctuation over the treatment course. AREAS COVERED: In the present narrative review the authors aim to provide a practical perspective on the recent evidence related to hypereosinophilia occurring during dupilumab therapy in respiratory indications, its underlying mechanisms, frequency, and clinical relevance, and to critically revise the currently proposed approaches to its management. Eosinophils increase is in most cases transient, spontaneously resolving, without any clinical relevance and no impact on efficacy. In fact, dupilumab safety profile is overall comparable with the other monoclonal antibody of the same drug class. EXPERT OPINION: Blood eosinophil count itself should not preclude dupilumab prescription, neither lead to dupilumab discontinuation, especially in the presence of ascertained drug efficacy and in the absence of signs suggesting a eosinophils-related complication. However, an extensive diagnostic work-up and regular follow-up monitoring is indicated, especially in patients with increased baseline eosinophils and coexisting nasal polyps and asthma.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".