Dr. Ahmed
Is Dupixent for Asthma or Eczema? Dupixent or Dupilumab has been FDA-approved for the treatment of both conditions.
It is indicated in the treatment of:
- Moderate to severe asthma
- Atopic dermatitis or Eczema
- Chronic rhinosinusitis with nasal polyposis, and
- It has been submitted for approval in the treatment of patients with intensely itchy skin nodules called Prurigo nodularis.
Introduction:
Asthma and eczema are quite common these days. With the passage of time and with the growing pollution and hazards in the world it is only logical that conditions like these are becoming more and more frequent.
Asthma has affected almost 25 million Americans, which equates to 1 in 13 people. [Ref]
Similarly, some sort of eczema is found in 31.6 million Americans, which equates to 1 in 10 people. [Ref]
What Do We Know About Dupixent (Dupilumab)?
Dupixent is a biological medication that is used to treat different conditions like asthma, atopic dermatitis, and nasal polyps.
It is also given for the treatment of eosinophilic esophagitis. Nasal polyps can be the cause of sinusitis.
It is a monoclonal antibody that blocks interleukin-4 and interleukin-13 by binding to the alpha subunits of these ILs.
Use of Dupixent in Asthma
In asthma, the airways get narrow and bulge out with excess mucus production. This results in conditions like shortness of breath along with coughing and wheezing, and sensations of tightness in the chest region can be felt as well.
Dupilumab, a biologic that is present under the name of Dupixent is available in the market. In clinical trials, it markedly improved the patients’ symptoms, reduced the frequency and severity of asthma exacerbations, and resulted in a reduction in the use of corticosteroids in patients with moderate to severe asthma [Ref].
Mechanism of action of Dupixent:
Interleukins are responsible for causing inflammation in our bodies. They signal the mast cells (also called mastocytes or labrocyte) to produce more and more Immunoglobulin E (IgE) antibodies causing inflammation.
When the process of inflammation begins, eosinophils mobilize themselves and come to the site of inflammation. Along with this systemic inflammation, local inflammation can occur in this region.
In this, the smooth muscle cells increase in numbers and the epithelial barrier is compromised. Airway smooth muscle cells are known to play a critical role in narrowing. Nitric oxide (NO) is released, causing increased production of mucus.
Dupixent blocks the signaling of interleukin 13 and 4 which results in decreased systemic inflammation and local inflammation that eventually leads to the symptoms of asthma being reduced.
Dupixent Effects (in 12-year-old children or above)
Asthma attacks are 81% lower in these children. About 86% of children leave their oral intake of steroidal medications prescribed by their doctor. So according to the above-mentioned results, it is effective in the treatment of asthma patients in children 12 years of age and above.
Dupixent Effects ( children below 12 )
Asthma attacks are 65% less with the use of Dupixent and a reduction in the use of oral steroids is seen by 66%.
Because Dupixent has not been studied in children younger than 12 years of age and its efficacy is not confirmed, corticosteroids should not be stopped unless and until your doctor prescribes them.
Administration of Dupixent in Asthma
According to the severity of the symptoms, 400 mg to 600 mg is injected once, which is followed by 200 mg to 300 mg subcutaneously after every two weeks along with corticosteroids.
Side Effects of Dupixent in Asthma
Dupixent can cause some severe side effects which are the following:
- Can cause allergic reactions like itching, skin rash, hives, etc.
- Can cause blood vessel inflammation especially if patients are taking steroidal medicines.
- Can cause pain in joints.
- The major & typical side impacts are oropharyngeal pain, parasitic infection, and injection spot infection.
Benefits of Dupixent in Asthma
- Prevent asthma attacks
- Prey asthma causing source
- Enhance lung functioning
- Ease in breathing
Overview of Eczema
Eczema could be an infection of the skin distinguished by redness, dryness, irritation, and tingling of the skin. Sometimes the skin gets rough as well.
It is also believed that atopic dermatitis is an autoimmune disease. It can be caused by eating nuts or dairy products, by environmental pollution like dust or pollen, or mites like parasites as well.
Taking a lukewarm bath, applying moisture, or wearing soft clothes can relieve the symptoms of eczema. Antihistaminic drugs may be useful in such situations.
There are seven types of eczema which are given below:
- Atopic eczema
- Contact dermatitis
- Dyshidrotic eczema
- Hand eczema
- Neurodermatitis
- Nummular eczema
- Stasis dermatitis
Almost all types of dermatitis have symptoms that are similar to one another. Sometimes the symptoms of eczema disappear with age as well.
Dupixent in Eczema
Eczema is also called atopic dermatitis. Dupixent is very fruitful in the treatment of eczema. The mechanism of action is the same in the case of eczema.
It prevents the process of inflammation, especially the local inflammation, which is one of the main reasons for causing atopic dermatitis.
The healing process is improved by using Dupixent, and there are no severe signs and symptoms of eczema. Dupixent is neither a steroid nor an immunosuppressant rather it is a biological medication.
Dupixent in Children with Eczema:
Dupixent is safe to use in children of 6 years along with adults. It is mostly prescribed when other dermatologic therapies do not give their effects maximally or fail to respond to the symptoms. It can be given with corticosteroids for topical application.
Administration of Dupixent in Eczema
Dupixent is given by injection subcutaneously. Syringes of 100 mg to 300 mg come from the company and then according to the requirement, the patient is either told how to inject it or is administered by some professional.
While in the case of children, the supervisor must be there to prevent the damage which can be due to negligence of children.
Side effects of Dupixent:
- Allergic reactions that swell the site of injection sometimes
- Eye color changes to pink
- Eyelid inflammation can occur
- Sores
- Eosinophilia
- Sometimes pain in joints can also occur
Benefits of Dupixent in Eczema
- The itching gets extremely reduced
- Skin gets clearer than before
- Sores around lips and mouth are diminished
- Redness disappears
- Dryness of skin vanishes
Long term use of Dupixent (Dupilumab):
As we know that asthma cannot be cured completely therefore patients with asthma have to be on some medications along with corticosteroids.
Similarly, eczema is also a chronic disorder so it cannot be cured totally. Such patients have to take lifelong treatment to ameliorate the symptoms.
In the case of severe to moderate asthma, the symptoms decline after at least 148 weeks so, it is safe to use for such a long period of duration.
The side effects of the use of Dupixent are normally short-lived. There is little chance that Dupixent can cause long-term side effects, particularly in eye vision.
