How does being on dupixent for eczema affect food allergy SPT and IgE testing?

I have multiple patients on Dupixent (atopic dermatitis, nasal polyps, asthma, and food allergies).

Most recently, a patient in their 60s with an IgE of 7,000 and Class 5 to shellfish with well-controlled asthma, chronic sinusitis/nasal polyps, atopic dermatitis, and food allergy to shellfish passed a challenge to crustacean shellfish (IgE 300, mite IgE RAST 4, crustacean shellfish 3).

Dupixent has been continuing for 7 years now. Other patients have had similar positive responses. She continues to ingest without problem and is very happy.

Food-specific IgE levels and skin tests get significantly smaller on Dupixent. See Spekhorst et al., PMID 36420598.

Despite this, many are still clinically reactive at these levels, whereas many others not on Dupixent might be passing the oral food challenge. That's my and my colleagues' experience. Haven't seen published data yet on this.