Drug updated on 4/18/2024
| Dosage Form | Pre-Filled Syringe Injection (subcutaneous; 100 mg/ 0.67 mL, 200 mg/1.14 mL, 300 mg/2 mL); Pre-Filled Pen Injection (subcutaneous; 200 mg/ 1.14 mL, 300 mg/ 2 mL) |
| Drug Class | Interleukin-4 receptor alpha antagonists |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- Indicated for the treatment of adult and pediatric patients aged 6 years and older with moderate-to-severe atopic dermatitis whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable.
- 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.
- Indicated as an add-on maintenance treatment in adult patients with inadequately controlled chronic rhinosinusitis with nasal polyposis (CRSwNP).
- Indicated for the treatment of adult and pediatric patients aged 12 years and older, weighing at least 40 kg, with eosinophilic esophagitis (EoE).
- Indicated for the treatment of adult patients with prurigo nodularis (PN).
Summary
- Dupilumab (Dupixent) is approved for the treatment of adult and pediatric patients aged 6 years and older with moderate-to-severe atopic dermatitis, asthma, chronic rhinosinusitis with nasal polyposis, eosinophilic esophagitis in those weighing at least 40 kg and aged 12 years or older, as well as prurigo nodularis in adults.
- A total of 30 systematic reviews/meta-analyses provide a comprehensive analysis of its effectiveness and safety across various conditions.
- In the treatment of Atopic Dermatitis (AD), dupilumab, when used in conjunction with topical corticosteroids, showed significant improvement. It enhanced Eczema Area Severity Index scores more than placebo, especially among pediatric populations, but higher doses of upadacitinib and abrocitinib were more effective.
- For patients with asthma, especially those with an eosinophilic phenotype or steroid-dependent asthma, dupilumab was effective in improving FEV1 levels while reducing treatment-emergent adverse events compared to traditional agents.
- In cases of Chronic Rhinosinusitis With Nasal Polyposis (CRSwNP), dupilumab use led to significant improvements in nasal polyp scores and quality of life indicators due to its good safety profile, highlighting the potential role of biologics in managing severe cases.
- Compared to JAK inhibitors such as lebrikizumab and tralokinumab, which offer a balance between efficacy and safety profiles, dupilumab's favorable long-term safety profile makes it a preferred option for certain patient subgroups despite its lower effectiveness in rapid symptom control in AD than these alternatives.
- Pediatric populations benefit significantly from Dupixent as it helps control AD symptoms, including severe itch, thus leading to quality of life improvements.
- Adults with moderate-to-severe AD, asthma, or CRSwNP showed varying degrees of response. Older patients and those with a history of long-term disease or hospitalizations due to respiratory illnesses are subgroups that might derive more benefit from Dupixent therapy.
Systematic Reviews / Meta-Analyses
Clinical Practice Guidelines
| Document Title | Year | Source |
|---|---|---|
| Guidelines of care for the management of atopic dermatitis in adults with phototherapy and systemic therapies. | 2024 | Journal of the American Academy of Dermatology |
| Executive summary: Japanese guidelines for atopic dermatitis (ADGL) 2021. | 2021 | Allergology International |
| EAACI biologicals guidelines-recommendations for severe asthma. | 2021 | Allergy |
| EAACI biologicals guidelines—dupilumab for children and adults with moderate-to-severe atopic dermatitis. | 2021 | Allergy |
| Atopic dermatitis in adults: an Australian management consensus. | 2019 | Australasian Journal of Dermatology |