Can Dupixent cure eczema?

Dupixent (dupilumab) is not a cure for eczema (also known as atopic dermatitis [AD]); however, it does effectively reduce symptoms in the majority of people prescribed it, such as:

• Itching
• The appearance of the rash
• The frequency of AD flares.

As well as:

• Improving skin quality
• Improving sleep
• Improving the quality of life.

However, there does appear to be a subset of people who only partially respond to Dupixent (partial responders), or who respond initially, and then their symptoms return (non-durable responders).

Experts estimate between two-thirds and three-fourths of people with atopic dermatitis (AD) do well on Dupixent. But many of these people will experience side effects, such as injection site reactions, eye problems (such as conjunctivitis or eye inflammation), and cold sores on the lips and mouth (oral herpes). Most of these side effects can be managed effectively with other treatments, such as eye drops or anti-virals, allowing people to continue with Dupixent, especially if it offers them significant benefits.

What are partial responders or non-durable responders to Dupixent?

Partial responders experience some relief of their symptoms but not as much as would be expected after 16 weeks of treatment. Non-durable responders do well on Dupixent at first but then the drug’s benefits gradually wear off. Researchers recommend that these people should continue taking Dupixent, but doctors are advised to boost their use of topical therapy, increase the dose of Dupixent or the frequency of administration, and consider phototherapy sessions along with an immunosuppressants.

Related questions

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

How does Dupixent work?

Dupixent is a human monoclonal IgG4 antibody that works by blocking the signaling (transmitting of messages) of two inflammatory proteins, called interleukin-4 (IL-4) and interleukin-13 (IL-13). It does this by binding to the site that these two proteins bind to, which is called the IL-4Rα subunit. When Dupixent occupies this subunit, it prevents IL-4 signaling via the Type I receptor and both IL-4 and IL-13 signaling through the Type II receptor.

Usually, interleukins play an important role in the immune system by helping to fight off invading organisms, such as bacteria and viruses. In eczema, the immune system becomes overreactive, and interleukins mistakenly attack the body. By blocking the effects of interleukins, Dupixent curbs this overreaction of the immune system, allowing the skin to repair and heal.

Research has also shown that in eczema, Dupixent helps to decrease colonization of a naturally occurring skin bacteria, called Staphylococcus, helping to normalize the skin microbiome. This improves the way a person’s immune system can function against infections.