What is Dupixent used for and how does it work?

Key Points

Dupixent (generic name: dupilumab) is approved by the FDA for five different uses: eczema (atopic dermatitis), asthma, nasal polyps (growths on the sinuses) accompanied by chronic rhinosinusitis (sinus and nasal cavity swelling), eosinophilic esophagitis (EoE), and prurigo nodularis (a skin condition). Dupixent works by lowering inflammation (swelling) that can lead to symptoms of these conditions.

Dupixent is a steroid-free, injectable biologic drug and is classified as an interleukin-4 (IL-4) receptor alpha antagonist. It is a monoclonal IgG4 antibody and works by blocking the IL-4 receptor site.

Dupixent works by lowering inflammation (swelling) that can lead to symptoms in eczema or asthma not controlled by other medications, or in chronic rhinosinusitis (long-term sinus inflammation) that is associated with nasal polyps. It can help improve inflammation, the ability to swallow and other symptoms in patients with eosinophilic esophagitis.

What is the mechanism of action for Dupixent?

Dupixent, an injectable interleukin-4 receptor alpha antagonist from Regeneron, was first approved by the FDA in March 2017. Dupixent also inhibits interleukin-13 (IL-13) by binding to a receptor (the IL-4Rα subunit) shared by the IL-4 and IL-13 receptor complexes. Dupixent blocks the action of IL-4 signaling via the Type I receptor and both IL-4 and IL-13 signaling through the Type II receptor.

Many different types of cells and compounds that cause inflammation express the IL-4Rα subunit. Examples include mast cells, eosinophils, histamine, cytokines, leukotrienes and others. It is thought that blocking IL-4Rα with Dupixent inhibits the inflammatory response from these compounds.

Can Dupixent be used in children?

Yes, Dupixent can be used in children and adolescents for certain conditions and at certain ages.

Dupixent is approved for use in adults and children at least 6 months of age for treatment of moderate-to-severe eczema (atopic dermatitis) when other topical therapies (used on the skin) are not effective or advisable. For eczema, Dupixent can be used with or without topical corticosteroids.

Dupixent is also used as an add-on maintenance treatment in patients 6 years of age and older with moderate-to-severe asthma with high levels of white blood cells known as eosinophils (eosinophilic phenotype) or with oral corticosteroid-dependent asthma. Dupixent is NOT used to treat an asthma attack. For sudden breathing symptoms, you should use a rescue inhaler such as albuterol.

Dupixent is approved to treat eosinophilic esophagitis (EoE) in patients 1 years of age and older, weighing at least 15 kg (33 lb).

Adults only: Dupixent is also used as an add-on maintenance treatment for adults only with chronic rhinosinusitis (sinus and nasal cavity swelling) with nasal polyposis (nasal polyps which are growths on the sinuses). It is also approved to treat prurigo nodularis, a skin condition characterized by hard and extremely itchy nodules that can worsen and spread. These uses are NOT approved for children.

Related Questions

• What are the most common skin conditions? (with photos)
• How fast does Dupixent work?
• Why do Dupixent injections hurt so much?

How is Dupixent supplied?

Dupixent comes as a single-use pre-filled syringe (with a needle shield) or as a pre-filled pen. It is supplied in a carton with two pens or syringes in each package. It is given as a subcutaneous (under the skin) injection.

The pre-filled pen contains a 200 mg or 300 mg dose. The pre-filled syringe comes in doses of 100 mg, 200 mg or 300 mg.

The Dupixent pre-filled pen is for use in patients 2 years of age and older. The prefilled syringe is for use in adults and children 6 months of age and older.

• Children younger than 12 years should receive their injection from an adult caregiver using the prefilled syringe.
• Adolescents 12 years to less than 18 years of age may inject themselves, BUT should do this under direct supervision of an adult.
• In children 6 months to less than 12 years of age, Dupixent should be given by a caregiver.

If your doctor decides that you or a caregiver can give the injections, you should receive training on how to prepare and inject Dupixent before your first dose.

Directions on how to use the injections are also included with your Dupixent package. The manufacturer supplies videos on their website to demonstrate Dupixent injection. If you have questions, ask your doctor, nurse or pharmacist.

See the detailed "Instructions for Use" here. Always use Dupixent exactly as prescribed by your doctor.

Bottom Line

• Dupixent is approved for use in moderate-to-severe eczema (atopic dermatitis), in moderate-to-severe asthma, in patients with chronic rhinosinusitis (sinus and nasal cavity swelling) and nasal polyps (growths on the sinuses), in eosinophilic esophagitis (EoE), and for prurigo nodularis (a skin condition).
• It is an injectable interleukin-4 receptor (IL-4) alpha antagonist that blocks receptors in the body to help lower inflammation that can lead to symptoms.
• Dupixent comes as an injection that is given under the skin (subcutaneous) by syringe or pen. Patients can be taught to use it at home by self-injection for adults and adolescents 12 years and older (with adult supervision). Children younger than 12 should receive their injection from an adult caregiver using the prefilled syringe.

This is not all the information you need to know about Dupixent (dupilumab) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.