Dupixent Side Effects in Children

Dupixent is a biological medicine approved for managing eczema, asthma, and other eosinophilic conditions.

Because it blocks IL-4 and IL-13, it is one of the most potent medicines for managing atopic and allergic conditions like asthma and atopic dermatitis.

It is approved for the treatment of refractory asthma and eosinophilic esophagitis in children 12 years of age or above. In addition, it has also been approved for treating eczema in children 6 years of age and above.

Children may be more susceptible to some side effects than adults. The most common being injection-site reactions and fear of injection phobia.

Dupixent and Eczema in Children:

Managing eczema in children is the most challenging as they are unable to properly mention what’s bothering them. As a result, eczema goes unnoticed and intensifies due to excessive scratching and recurrent flare-ups.

Even with topical creams, it is still impossible to keep your child from scratching at the affected skin. Moreover, uncontrolled eczema greatly affects your child’s ability to focus, leaving him irritated and restless.

Other than topical corticosteroids, Dupixent is the only FDA-approved medication that can be used in children from 6 months to 5 years.

Moreover, parents often fear new treatments for their children, especially when the previous ones haven’t been fruitful.

Is Dupixent Safe for Children?

Dupixent (dupilumab) has undergone various trials to test its effectiveness and safety in children. The majority of the clinical trials have declared Dupixent safe for use in children with severe eczema or atopic dermatitis.

According to studies, Dupixent (dupilumab) is safe to use in children with moderate to severe atopic dermatitis. [Ref]

In a double-blind, 16-week trial with 367 patients aged 6 months to 11 years, dupilumab along with corticosteroid therapy was seen as effective and well-tolerated.

The study reported injection-site reactions and conjunctivitis as the most observed side effects. [Ref]

In a recent 4 year study, it was suggested that Dupixent possesses an overall lesser infection risk. [Ref].

Common Dupixent Side Effects in Children

While Dupixent is the safest and only FDA-approved drug for eczema treatment in children, it still has some side effects.

The most commonly reported side effects in children include:

• Injection Site Reactions

The most common issue with Dupixent administration is injection site reactions.

Although the treatment occurs with a sufficient gap, still injection site issues like redness, swelling, and pain are observed.

• Eye Infections

Eye infections, predominantly conjunctivitis or pink eye infection are recurrent as compared to others like blepharitis (eyelid inflammation).

Blurry vision is often associated with these infections. Regular eye examinations are recommended to be on the safe side while on Dupixent therapy.

Alternatively, mild eye infections can be managed by using OTC eye drops for dry and irritated eyes.

You can also use a cold compress for temporary eye relief. However, if you suspect an infection visit your doctor right away.

• Herpes Infections

Due to the immune-suppressive activity of Dupilumab, patients become susceptible to the herpes virus resulting in cold sores and shingles. Oral herpes or cold sores can occur on lips or mouth as tiny blisters.

Cold sores normally go away within 2 weeks, but in children, this requires faster healing. You can use OTC antiviral creams to ease the symptoms of cold sores.

• Allergic Reactions

Allergic reactions are rarely caused by Dupixent. Mild allergic reactions such as skin rash, flushing, or hives were rarely reported in studies.

In some rare cases, Dupixent therapy can aggravate eczema symptoms and lead to recurrent flare-ups. Inform your doctor if you experience worsening symptoms in your child after starting therapy.

• Joint Pain

Another usual side effect is joint pain that leads to difficulty in walking. This side effect often goes unnoticed in children so look carefully for any changes in your child’s walk or if your child complains about any pains.

Less Common Dupixent Side Effects in Children:

Other mild and rare symptoms include:

• Diarrhea
• Stomach cramps
• Toothache
• Throat infections
• Muscle pain

How to Safely Administer Dupixent?

Ideally, it should be injected by a nurse or trained staff at a hospital. But for home administration (only after suggested by the doctor) follow these instructions:

• Learn how to inject Dupixent from your nurse or doctor. Then get some practice before you start injecting yourself.
• Inject it in the fatty parts of the body like the upper arms, lower abdomen, or thighs.
• Avoid injecting within 2 inches of the belly button.
• Do not inject at the same spot twice, keep changing the sites.
• If the dose includes 2 injections, inject both at different sites.
• Store the drug in its original packing inside a refrigerator and do not shake before use.
• Avoid injecting it into any bruised, scarred, or infected skin areas.
• Use the syringe only once and dispose of the used needles. Do not reuse the needles.

Why is Dupixent Use in Children a Complex Decision?

Dupixent is a highly effective drug in treating eczema but parents often find it a difficult decision because of the following issues:

• Dupixent therapy requires injections at regular intervals which makes it a tough choice as compared to other topical creams that are rather easy to apply.
• Moreover, injections can be a cause of anxiety and fear in some children which makes administration often very challenging for both parents and healthcare professionals
• Dupixent is a new treatment option that lacks long-term safety data, especially in children. That is why, it is only recommended for moderate to severe cases of eczema.
• Dupixent is an expensive medicine, and getting it on insurance is crucial to avoid any additional financial burden.

Conclusion

Dupixent has transformed the lives of eczema patients. However, there is still a need to weigh the risks and benefits before starting the treatment in children.

Managing the common side effects in children can be tricky. That is why open communication between parents and doctors is necessary to get a clear picture of both the potential risks and the promised outcomes.