From the Guidelines
Dupixent (dupilumab) is used to treat moderate-to-severe atopic dermatitis (eczema), moderate-to-severe asthma, chronic rhinosinusitis with nasal polyps, and eosinophilic esophagitis. It works by blocking specific proteins called interleukins (IL-4 and IL-13) that contribute to inflammation in these conditions. For chronic rhinosinusitis with nasal polyps, dupilumab has been shown to significantly decrease nasal polyp score, improve smell, and reduce rhinosinusitis disease severity, as seen in a study published in 2020 1. The study found that dupilumab reduced the nasal polyp score by a mean of -1.79 (95% CI -2.01 – -1.56) and improved smell as measured by the UPSIT score by a mean of 10.83 (95% CI 9.59 – 12.08). In addition, dupilumab has been found to be beneficial for patients with comorbid diseases, such as atopic dermatitis and CRSwNP, as it can improve both conditions simultaneously, as discussed in a guideline published in 2023 1. The use of dupilumab is generally recommended for patients who have not responded adequately to conventional treatments, and it is typically administered as a subcutaneous injection every two weeks after an initial loading dose. Common side effects of dupilumab include injection site reactions, conjunctivitis, and rarely, hypersensitivity reactions. Patients should continue their other medications as prescribed by their healthcare provider while using dupilumab. It is essential to consider the individual patient's disease severity, comorbidities, and preferences when deciding to initiate dupilumab therapy, as outlined in the guideline published in 2023 1. The guideline suggests that patients with high baseline disease severity may benefit more from dupilumab, while those with low disease burden may prefer to avoid the burden of systemic therapy with a biologic. Overall, dupilumab is a valuable treatment option for patients with moderate-to-severe atopic dermatitis, asthma, chronic rhinosinusitis with nasal polyps, and eosinophilic esophagitis, and its use should be considered on a case-by-case basis.
From the FDA Drug Label
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. 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 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). 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). DUPIXENT is indicated for the treatment of adult patients with prurigo nodularis (PN). 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 (AD): moderate-to-severe AD in patients 6 months and older
- Asthma: moderate-to-severe asthma with an eosinophilic phenotype or oral corticosteroid dependent asthma in patients 6 years and older
- Chronic Rhinosinusitis with Nasal Polyps (CRSwNP): inadequately controlled CRSwNP in patients 12 years and older
- Eosinophilic Esophagitis (EoE): EoE in patients 1 year and older, weighing at least 15 kg
- Prurigo Nodularis (PN): PN in adult patients
- Chronic Obstructive Pulmonary Disease (COPD): inadequately controlled COPD with an eosinophilic phenotype in adult patients 2
From the Research
Dupixent (Dupilumab) Treatments
- Dupixent (dupilumab) is used to treat various type 2 inflammatory diseases, including:
- The medication works by blocking the interleukin-4 receptor alpha (IL-4Rα) subunit, which inhibits IL-4 and IL-13, major drivers of human type 2 inflammatory disease 4, 3
Specific Conditions Treated by Dupilumab
- Atopic dermatitis (AD): dupilumab has been approved for adult patients with moderate to severe AD since 2018 3
- Asthma: dupilumab has been approved for uncontrolled asthma since 2019 3
- Chronic rhinosinusitis with nasal polyps (CRSwNP): dupilumab has demonstrated efficacy and acceptable safety in treating CRSwNP, reducing nasal polyp burden and improving symptoms 4, 5, 6
Benefits of Dupilumab Treatment
- Rapid onset of response across three type 2 inflammatory diseases (AD, asthma, and CRSwNP) 7
- Improved symptoms and quality of life in patients with AD, asthma, and CRSwNP 4, 5, 7
- Reduced use of systemic corticosteroids and need for nasal polyp surgery in patients with CRSwNP 4
- Described as a valuable treatment option for adults with inadequately controlled CRSwNP 4