Pharm

Dupilumab

search

Dupilumab, Dupixent, Interleukin-4 Alpha Receptor Antagonist

  • See Also
  1. Asthma Monoclonal Antibody
  2. Severe Persistent Asthma
  3. Asthma Management
  4. Omalizumab
  5. Benralizumab
  6. Mepolizumab
  7. Reslizumab
  8. Dupilumab
  • Indications
  1. See Asthma Monoclonal Antibody
  2. Moderate to severe refractory, persistent Asthma
    1. High Eosinophil Counts or on chronic Systemic Corticosteroids
  3. Other Indications
    1. Eosinophilic Esophagitis
    2. Severe Atopic Eczema
    3. Chronic Sinusitis with Nasal Polyps
  • Background
  1. As of 2022, approved for use down to age 6 years for moderate to severe Eczema
  2. Costs $3400/month in 2022, U.S.
  • Precautions
  1. Live Vaccines are best completed at least 4 weeks before starting agent
  • Mechanism
  1. Interleukin-4/13 Alpha Receptor Antagonist
  • Adverse Effects
  1. See Asthma Monoclonal Antibody
  2. Eye (Conjunctivitis, Dry Eyes)
  3. Alopecia
  4. Arthralgias
  5. Rash
  6. Gastritis
  7. Pharyngitis (2%)
  8. Insomnia
  9. Secondary infection (Oral HSV, Helminths)
  10. Injection site reactions (16%)
  11. Eosinophilia (2%)
  • Dosing
  1. Adult: 600 mg SQ once, then 300 mg SQ every 2 weeks
  2. Child (age 6 to 11 years)
    1. Weight 15 to 30 kg: 100 mg SQ every 2 weeks OR 300 mg SQ every 4 weeks
    2. Weight >30 kg: 200 mg SQ every 2 weeks
  • Resources
  1. Biologic Therapy in Asthma
    1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5405559/
  2. Dupilumab (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=595f437d-2729-40bb-9c62-c8ece1f82780
  • References
  1. (2022) Comparison of Asthma Medications, Presc Lett, #381217
  2. (2020) Drugs for Asthma, Med Lett Drug Ther 62: 193-200
  3. (2022) Presc Lett 29(7): 40-1
  4. (2018) Biologics for Asthma, Presc Lett
  5. Castro (2018) N Engl J Med 378(26):2486-96 [PubMed]
  6. Rabe (2018) N Engl J Med 378(26): 2475-85 [PubMed]
  7. Narasimhan (2021) Am Fam Physician 103(5): 286-90 [PubMed]
  8. Raymond (2023) Am Fam Physician 107(4): 358-68 [PubMed]