Is Dupixent an immunosuppressant?

No, Dupixent (dupilumab) is not an immunosuppressant or a steroid. Dupixent works by targeting a type of protein called an interleukin, that is involved in inflammation. Dupixent calms an overreactive immune system but does not suppress the immune system. This leads to fewer and less severe episodes of inflammation when used to treat conditions such as eczema, asthma, COPD, rhinosinusitis, esophagitis, and prurigo nodularis.

No study has reported so far that Dupixent reactivates latent infections, such as tuberculosis or hepatitis B, increases the risk of invasive fungal infections or unusual opportunistic infections, nor increases the progression of cancer. Most medicines that have immunosuppressive properties increase the risk of all of these.

Dupixent injection may be used to treat moderate-to-severe eczema in adults and children aged 6 months and older whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable. It may also be used to treat moderate-to-severe asthma in adults and children aged 6 years and older in addition to other therapies; inadequately controlled COPD with an eosinophilic phenotype as an add-on maintenance treatment in adults; eosinophilic esophagitis in adults and children aged 1 year and older, weighing at least 33 pounds (15 kg); chronic rhinosinusitis with nasal polyps in adults and children aged 12 and older; and to significantly reduce itch and skin lesions in adults with prurigo nodularis.

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 some chronic conditions, such as atopic dermatitis (also called eczema), the immune system becomes over-reactive, 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.

How Dupixent works in asthma and chronic rhinosinusitis is not completely understood; however, it is believed to be due to an inhibition of the IL-4 and IL-13 cytokine-induced inflammatory response which reduces the release of other inflammatory substances, such as proinflammatory cytokines, chemokines, nitric oxide, and IgE.

For eosinophilic esophagitis (EoE), Dupixent targets interleukins and relieves the underlying source of inflammation that contributes to EoE, reducing EoE symptoms. Until Dupixent, treatment options were limited to proton pump inhibitors (PPIs), swallowed topical corticosteroids, and food elimination diets.

By controlling inflammation associated with interleukins under the skin associated with prurigo nodularis, Dupixent helps bring balance back between your skin, nervous system, and immune system.

For COPD, Dupixent relieves underlying inflammation caused by interleukins that can cause breathing difficulties and an increase in COPD flare-ups.

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