Why does Dupixent cause eye problems?
Dupixent (dupilumab) is associated with several different eye problems, including conjunctivitis, blepharitis, dry eyes, itchy eyes, and keratitis. The cause of the eye problems is likely to be the same mechanism that makes Dupixent effective against eczema, asthma, COPD, rhinosinusitis, esophagitis, and prurigo nodularis.
Dupixent is a human monoclonal IgG4 antibody that works by blocking two inflammatory proteins, called interleukin-4 (IL-4) and interleukin-13 (IL-13). Unfortunately, goblet cells, which are responsible for creating mucus in the eye and ensuring the stability of tears, are also stimulated by IL-13. So, when Dupixent blocks IL-13 which helps resolve the symptoms of the conditions it is approved for, it also lowers the numbers of epithelial goblet cells, leading to inflammation and eye problems.
Most of the time the inflammation is not too severe, but in some people, Dupixent may need to be discontinued. Most eye problems respond to standard treatments, for example, antibacterial eye drops for bacterial conjunctivitis or eye lubricants for dry eye. Eye problems reported with Dupixent include:
- Conjunctivitis (inflammation of the conjunctiva [the lining of the eye] due to allergic, bacterial, or viral causes), giant papillary conjunctivitis, eye irritation, and eye inflammation. Reported by 10% of people
- Itchy eyes. Reported by 1% of people
- Dry eye. Reported by less than 1% of people
- Blepharitis (inflammation along the edges of the eyelids). Reported by less than 1% of people
- Keratitis (inflammation of the cornea). Reported by less than 1% of people.
References
- Proceed With Caution. Review of Optometry Nov 15th 2019 https://www.reviewofoptometry.com/article/proceed-with-caution
- Dupixent Prescribing Information https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/761055s064lbl.pdf
- Dupixent Patient Information https://www.regeneron.com/downloads/dupixent_ppi.pdf
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Dupixent (dupilumab) injections can cause discomfort for some people. The amount of discomfort can depend on many factors.
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How fast does Dupixent work?
Dupixent (generic name: dupilumab) can start to work in 2 to 4 weeks to relieve symptoms associated with inflammatory conditions like eczema, asthma, and sinus swelling due to nasal polyps. In studies, improvements were seen at 12 weeks in some patients with chronic obstructive pulmonary disease (COPD), prurigo nodularis and chronic spontaneous urticaria; at 16 weeks with bullous pemphigoid; and at 24 weeks for eosinophilic esophagitis.
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Does Dupixent cause weight gain?
Yes, it does appear that Dupixent can cause weight gain, although this is not listed as a side effect in the product information. A case series of 12 people prescribed Dupixent reported an average weight gain of 6.1kg over one year – the amount of weight gained ranged from 0.1kg to 18.0kg. Anecdotally, blog sites also report weight gain as a side effect. How Dupixent causes weight gain is not known; however, people should be informed that weight gain may be a possible side effect of Dupixent. Continue reading
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