From the Guidelines
Dupixent (dupilumab) is a biologic medication that treats several inflammatory conditions, including moderate-to-severe atopic dermatitis, moderate-to-severe asthma, and chronic rhinosinusitis with nasal polyps, by blocking interleukin-4 and interleukin-13, key proteins involved in type 2 inflammation.
Conditions Treated by Dupixent
- Moderate-to-severe atopic dermatitis (eczema)
- Moderate-to-severe asthma
- Chronic rhinosinusitis with nasal polyps
Mechanism of Action and Administration
Dupixent works by blocking interleukin-4 and interleukin-13, which are key proteins involved in type 2 inflammation that contribute to these conditions 1. The medication is administered as a subcutaneous injection, typically every two weeks after an initial loading dose.
Efficacy and Safety
According to the european position paper on rhinosinusitis and nasal polyps 2020, dupilumab has been shown to significantly decrease symptoms of chronic rhinosinusitis with nasal polyps, including nasal congestion, loss of smell, and nasal polyp size 1. The joint task force on practice parameters grade guidelines for the medical management of chronic rhinosinusitis with nasal polyposis also recommends dupilumab as a treatment option for patients with chronic rhinosinusitis with nasal polyps who have not responded to other treatments 1.
Side Effects
Common side effects of dupilumab include injection site reactions, conjunctivitis (particularly in dermatitis patients), and cold sores 1. However, the most common adverse events were more frequent with placebo, and dupilumab seems to induce conjunctivitis in trials in patients with atopic dermatitis but no trials with asthma and CRSwNP 1.
From the FDA Drug Label
1.1 Atopic Dermatitis DUPIXENT is indicated for the treatment of adult and pediatric patients aged 6 months and older with moderate-to-severe atopic dermatitis (AD) whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable. 1.2 Asthma DUPIXENT is indicated as an add-on maintenance treatment of adult and pediatric patients aged 6 years and older with moderate-to-severe asthma characterized by an eosinophilic phenotype or with oral corticosteroid dependent asthma. 1.3 Chronic Rhinosinusitis with Nasal Polyps DUPIXENT is indicated as an add-on maintenance treatment in adult and pediatric patients aged 12 years and older with inadequately controlled chronic rhinosinusitis with nasal polyps (CRSwNP). 1.4 Eosinophilic Esophagitis DUPIXENT is indicated for the treatment of adult and pediatric patients aged 1 year and older, weighing at least 15 kg, with eosinophilic esophagitis (EoE). 1.5 Prurigo Nodularis DUPIXENT is indicated for the treatment of adult patients with prurigo nodularis (PN). 1.6 Chronic Obstructive Pulmonary Disease DUPIXENT is indicated as an add-on maintenance treatment of adult patients with inadequately controlled chronic obstructive pulmonary disease (COPD) and an eosinophilic phenotype.
Dupixent (dupilumab) treats:
- Atopic Dermatitis: moderate-to-severe atopic dermatitis (AD) in adult and pediatric patients aged 6 months and older
- Asthma: moderate-to-severe asthma in adult and pediatric patients aged 6 years and older
- Chronic Rhinosinusitis with Nasal Polyps: inadequately controlled chronic rhinosinusitis with nasal polyps (CRSwNP) in adult and pediatric patients aged 12 years and older
- Eosinophilic Esophagitis: eosinophilic esophagitis (EoE) in adult and pediatric patients aged 1 year and older, weighing at least 15 kg
- Prurigo Nodularis: prurigo nodularis (PN) in adult patients
- Chronic Obstructive Pulmonary Disease: inadequately controlled chronic obstructive pulmonary disease (COPD) with an eosinophilic phenotype in adult patients 2
From the Research
Conditions Treated by Dupixent (Dupilumab)
- Atopic dermatitis: Dupilumab is approved for the treatment of adult patients with moderate-to-severe atopic dermatitis 3, 4, 5, 6
- Asthma: Dupilumab is approved for the treatment of uncontrolled asthma 4, 7
- Chronic rhinosinusitis with nasal polyps (CRSwNP): Dupilumab is approved for the treatment of adults with inadequately controlled CRSwNP 3, 4, 7
- Alopecia areata: Dupilumab has been found to be effective in treating alopecia areata, although more investigation is required to understand its broadening clinical indications 5