What is the standard starting dose of Dupixent (dupilumab) for a patient with moderate to severe atopic dermatitis?

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Standard Starting Dose for Dupixent in Atopic Dermatitis

For adults with moderate to severe atopic dermatitis, the standard starting dose of Dupixent (dupilumab) is 600 mg (administered as two 300 mg subcutaneous injections), followed by 300 mg every 2 weeks. 1

Adult Dosing

  • The initial loading dose is 600 mg given as two separate 300 mg subcutaneous injections 2, 1
  • Maintenance dosing is 300 mg every 2 weeks (Q2W) following the loading dose 2, 1
  • This regimen is FDA-approved and represents the standard dosing for adults 1

Pediatric Dosing Considerations

For pediatric patients 6 years and older, dosing is weight-based 1:

  • 15 to <30 kg: 600 mg loading dose (two 300 mg injections), then 300 mg every 4 weeks 1
  • 30 to <60 kg: 400 mg loading dose (two 200 mg injections), then 200 mg every 2 weeks 1, 3
  • ≥60 kg: 600 mg loading dose (two 300 mg injections), then 300 mg every 2 weeks 1, 3

For children 6 months to 5 years, no loading dose is used 1:

  • 5 to <15 kg: 200 mg every 4 weeks 1
  • 15 to <30 kg: 300 mg every 4 weeks 1

Administration Details

  • Dupixent is administered via subcutaneous injection into the thigh, abdomen (avoiding 2 inches around the navel), or upper arm (if administered by a caregiver) 1
  • When giving the loading dose, administer each injection at different injection sites 1
  • Rotate injection sites with each subsequent dose 1

Clinical Context and Efficacy

The 2024 American Academy of Dermatology guidelines identify dupilumab as the preferred first-line systemic agent for moderate to severe atopic dermatitis, with all guideline workgroup members favoring it over other systemic therapies 2. This standard dosing regimen (600 mg loading, then 300 mg Q2W) has demonstrated:

  • Excellent safety profile in clinical trials with over 5 years of clinical practice data 2
  • Significant improvements in disease severity, quality of life, and pruritus compared to placebo 2
  • Comparable efficacy to upadacitinib 15 mg daily and superior efficacy to abrocitinib 100 mg daily 2

Concomitant Therapy

  • Dupixent can be used with or without topical corticosteroids 1
  • Topical calcineurin inhibitors may be reserved for problem areas such as face, neck, intertriginous, and genital areas 1

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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