What is Dupixent (dupilumab)?

From the Guidelines

Dupixent (dupilumab) is a biologic medication used primarily to treat moderate-to-severe atopic dermatitis, asthma, chronic rhinosinusitis with nasal polyps, and eosinophilic esophagitis, by blocking interleukin-4 and interleukin-13, key proteins involved in type 2 inflammation, as shown in a study published in the British Journal of Dermatology in 2024 1.

Key Points

• The standard adult dose for atopic dermatitis is 300mg injected subcutaneously every two weeks, with an initial loading dose of 600mg (two 300mg injections) 1.
• For asthma, dosing varies based on weight and other factors, typically 200-300mg every two weeks 1.
• Dupixent is self-administered via pre-filled syringes or auto-injectors that should be stored in the refrigerator but brought to room temperature before injection 1.
• Common side effects include injection site reactions, conjunctivitis (particularly in dermatitis patients), and rarely, hypersensitivity reactions 1.
• Unlike many immunosuppressants, Dupixent doesn't broadly suppress the immune system, making it safer regarding infection risk, as noted in a study published in Rhinology in 2020 1.
• Treatment is typically long-term, with improvement often seen within 2-4 weeks for skin conditions and 2-3 months for respiratory conditions 1.

Administration and Storage

• Dupixent should be stored in the refrigerator at 2°C to 8°C (36°F to 46°F) 1.
• It should be brought to room temperature before injection, and administered via pre-filled syringes or auto-injectors 1.

Side Effects and Management

• Ocular surface disorders, such as conjunctivitis and dry eye, are common side effects of Dupixent, particularly in patients with atopic dermatitis, as reported in a study published in the British Journal of Dermatology in 2024 1.
• Management of these side effects may include topical lubricants, antihistamine eyedrops, and referral to ophthalmology for severe cases, as recommended in a study published in the British Journal of Dermatology in 2024 1.

From the FDA Drug Label

DUPIXENT is a prescription medicine used: to treat adults and children 6 months of age and older with moderate-to-severe eczema (atopic dermatitis or AD) that is not well controlled with prescription therapies used on the skin (topical), or who cannot use topical therapies with other asthma medicines for the maintenance treatment of moderate-to-severe asthma in adults and children 6 years of age and older whose asthma is not controlled with their current asthma medicines. with other medicines for the maintenance treatment of chronic rhinosinusitis with nasal polyps (CRSwNP) in adults and children 12 years of age and older whose disease is not controlled to treat adults and children 1 year of age and older with eosinophilic esophagitis (EoE), who weigh at least 33 pounds (15 kg). to treat adults with prurigo nodularis (PN) with other medicines for the maintenance treatment of adults with inadequately controlled chronic obstructive pulmonary disease (COPD) and a high number of blood eosinophils (a type of white blood cell that may contribute to your COPD).

Dupixent (dupilumab) is a prescription medicine used to treat various conditions, including:

• Moderate-to-severe eczema (atopic dermatitis) in adults and children 6 months of age and older
• Moderate-to-severe asthma in adults and children 6 years of age and older
• Chronic rhinosinusitis with nasal polyps in adults and children 12 years of age and older
• Eosinophilic esophagitis in adults and children 1 year of age and older
• Prurigo nodularis in adults
• Inadequately controlled chronic obstructive pulmonary disease (COPD) in adults with a high number of blood eosinophils 2

From the Research

Definition and Mechanism of Dupixent (Dupilumab)

• Dupixent (dupilumab) is a fully human IgG4 monoclonal antibody that targets the interleukin (IL)-4 receptor α (IL-4Rα) subunit, inhibiting the signaling of IL-4 and IL-13, which are key drivers of type 2 inflammatory diseases such as asthma, atopic dermatitis, and chronic rhinosinusitis with nasal polyps (CRSwNP) 3, 4.
• By binding to and blocking the IL-4Rα subunit, dupilumab prevents the activation of the type I IL-4 and type II IL-4/IL-13 receptor complexes, thereby reducing inflammation and improving symptoms in patients with these conditions 3, 4.

Indications and Efficacy

• Dupilumab is approved for the treatment of adults with moderate-to-severe atopic dermatitis, CRSwNP, and asthma, and has been shown to improve symptoms, reduce inflammation, and enhance quality of life in these patients 3, 4, 5, 6.
• Clinical trials have demonstrated the efficacy and safety of dupilumab in reducing nasal polyp size, sinus opacification, and symptoms of CRSwNP, as well as improving skin disease activity and quality of life in patients with atopic dermatitis 3, 5, 6.

Safety and Tolerability

• Dupilumab has been shown to be generally well-tolerated, with common adverse events including injection-site reactions and conjunctivitis 6, 7.
• Laboratory tests have found no clinically significant changes in blood cells, blood chemistry, or urine chemistry in patients treated with dupilumab, suggesting that routine laboratory testing may not be necessary for patients using this medication 7.