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Response to : ‘Interleukin-4 as a emerging target for IgG4-related disease’ by Akiyama et al
  1. Rachel S Simpson,
  2. Jason K Lee
  1. Toronto Allergists, Toronto, Ontario, Canada
  1. Correspondence to Ms Rachel S Simpson, Toronto Allergists, Toronto, ON M5G 1E2, Canada; rachel.simpson{at}

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We thank Akiyama et al, for their kind words regarding our manuscript.1 We agree that IgG4-related disease (IgG4-RD) relapse frequently occurs in patients tapering glucocorticoids, and we wanted to offer a novel solution to our patient to potentially mitigate or all together avoid this. As communicated in our previous correspondence response2 it has actually come to our attention post-publication (December 29th, 2019) that the patient noted in our report never took a dose of prednisone that was prescribed to him due to undisclosed non-compliance. Therefore, the remission of IgG4-RD can be completely attributed to dupilumab treatment. We are happy to report our findings and hope that our report will propel this treatment to be studied further for the treatment of this disease which otherwise, as you mentioned, is poorly controlled by glucocorticoids especially when tapering,3 and when other agents such as chemotherapeutic immunosuppressants come with profound adverse effects.4 Although this disease has a low prevalence, so low that it is actually unknown due to being underrecognized …

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