From the Guidelines
Dupilumab is not currently FDA-approved for Crohn's disease treatment and should not be used as a primary treatment for this condition. While dupilumab (brand name Dupixent) is effective for treating atopic dermatitis, asthma, chronic rhinosinusitis with nasal polyps, and eosinophilic esophagitis, it has not shown significant efficacy in Crohn's disease clinical trials 1. For Crohn's disease, approved biologic treatments include anti-TNF agents (infliximab, adalimumab, certolizumab pegol), anti-integrin therapy (vedolizumab), anti-IL-12/23 therapy (ustekinumab), and anti-IL-23 therapy (risankizumab) 1. These medications target different inflammatory pathways involved in Crohn's disease pathogenesis. Dupilumab works by blocking IL-4 and IL-13 signaling, which are not primary pathways in Crohn's disease inflammation.
Some key points to consider when treating Crohn's disease include:
- The use of anti-TNF agents, such as infliximab and adalimumab, as first-line therapy for moderate to severe luminal Crohn's disease with risk factors of poor prognosis 1.
- The use of vedolizumab as an alternative to anti-TNF therapy in patients who have failed or are intolerant to anti-TNF therapy 1.
- The use of ustekinumab as an alternative to anti-TNF therapy in patients who have failed or are intolerant to anti-TNF therapy 1.
- The importance of individualizing treatment choices based on patient preference, cost, likely adherence, safety data, and speed of response to the drug 1.
If you have both Crohn's disease and a condition that dupilumab treats (like atopic dermatitis), you would likely need separate treatments for each condition. Always consult with both a gastroenterologist and dermatologist to coordinate care for multiple conditions.
From the Research
Relationship Between Crohn's Disease and Dupilumab
There are no research papers to assist in answering this question, as none of the provided studies mention dupilumab in relation to Crohn's disease.
Available Treatments for Crohn's Disease
- Aminosalicylates, corticosteroids, immunomodulators, and biologics are primary agents used in the treatment of Crohn's disease 2, 3
- Biologics available include anti-TNF agents, anti-integrins, and anti-interleukins 3
- Ustekinumab, a monoclonal antibody to the shared p40 subunit of the proinflammatory interleukin (IL)-12 and IL-23 cytokines, has been approved for moderately to severely active Crohn's disease 4
- Vedolizumab and ustekinumab can be used as second-line therapies in patients with Crohn's disease who have failed TNF-alpha inhibitors 5
Efficacy of Ustekinumab and Vedolizumab
- Ustekinumab and vedolizumab showed similar clinical effectiveness after 26 weeks of treatment in patients with Crohn's disease who had failed TNF-alpha inhibitors 5
- At 1 year, vedolizumab was associated with a higher rate of clinical remission compared to ustekinumab 5
- Objective response and remission rates were similar between ustekinumab and vedolizumab at week 52 5