Key Points

• Dupixent (generic name: dupilumab) is approved by the FDA for five different uses: for use in moderate-to-severe eczema (atopic dermatitis), in moderate-to-severe asthma, in patients with nasal polyps (growths on the sinuses) accompanied by chronic rhinosinusitis (sinus and nasal cavity swelling), in eosinophilic esophagitis (EoE), and for prurigo nodularis, a a skin condition that consists of hard and extremely itchy nodules that can worsen and spread.
• Dupixent is a steroid-free, injectable biologic drug and is classified as an interleukin-4 (IL-4) receptor alpha antagonist. It is a monoclonal IgG4 antibody and works by blocking the IL-4 receptor site.
• Dupixent works by lowering inflammation (swelling) that can lead to symptoms in eczema or asthma not controlled by other medications, or in chronic rhinosinusitis (long-term sinus inflammation) that is associated with nasal polyps. It can help improve inflammation and the ability to swallow in patients with eosinophilic esophagitis.

What is the mechanism of action for Dupixent?

Dupixent, an injectable interleukin-4 receptor alpha antagonist from Regeneron, was first approved by the FDA in March 2017. Dupixent also inhibits interleukin-13 (IL-13) by binding to a receptor (the IL-4Rα subunit) shared by the IL-4 and IL-13 receptor complexes. Dupixent blocks the action of IL-4 signaling via the Type I receptor and both IL-4 and IL-13 signaling through the Type II receptor.

Many different types of cells and compounds that cause inflammation express the IL-4Rα subunit. Examples include mast cells, eosinophils, histamine, cytokines, leukotrienes and others. It is thought that blocking IL-4Rα with Dupixent inhibits the inflammatory response from these compounds.

Can Dupixent be used in children?

Yes, for certain conditions and at certain ages.

• Dupixent is approved for use in adults and children at least 6 months of age for treatment of moderate-to-severe eczema (atopic dermatitis) when other topical therapies (used on the skin) are not effective or advisable. For eczema, Dupixent can be used with or without topical corticosteroids.
• Dupixent is also used as an add-on maintenance treatment in patients 6 years of age and older with moderate-to-severe asthma with high levels of white blood cells known as eosinophils (eosinophilic phenotype) or with oral corticosteroid-dependent asthma. Dupixent is NOT used to treat an asthma attack. For sudden breathing symptoms, you should use a rescue inhaler such as albuterol.
• Dupixent is approved to treat eosinophilic esophagitis (EoE) in patients 12 years of age and older, weighing at least 40 kg (88 lb).

Adults only: Dupixent is also used as an add-on maintenance treatment for adults only with chronic rhinosinusitis (sinus and nasal cavity swelling) with nasal polyposis (nasal polyps which are growths on the sinuses). It is also approved to treat prurigo nodularis, a skin condition characterized by hard and extremely itchy nodules that can worsen and spread. These uses are NOT approved for children.

How is Dupixent supplied?

Dupixent comes as a single-use pre-filled syringe (with a needle shield) or as a pre-filled pen. It is supplied in a carton with two pens or syringes in each package. It is given as a subcutaneous (under the skin) injection.

• The Dupixent pre-filled pen is only for use in patients 12 years of age and older.
• Children younger than 12 years should receive their injection from an adult caregiver using the prefilled syringe.
• The pre-filled pen contains a 200 mg or 300 mg dose.
• The pre-filled syringe comes in doses of 100 mg, 200 mg or 300 mg.

If your doctor decides that you or a caregiver can give the injections, you should receive training on how to prepare and inject Dupixent before your first dose.

Adults should supervise children 12 years of age and older. In children younger than 12 years of age, Dupixent should be given by an adult parent or caregiver from the prefilled syringe.

Directions on how to use the injections are also included with your Dupixent package. The manufacturer supplies videos on their website to demonstrate Dupixent injection. If you have questions, ask your doctor, nurse or pharmacist.

See the detailed "Instructions for Use" here. Always use Dupixent exactly as prescribed by your doctor.

Bottom Line

• Dupixent is approved for use in moderate-to-severe eczema (atopic dermatitis), in moderate-to-severe asthma, in patients with chronic rhinosinusitis (sinus and nasal cavity swelling) and nasal polyps (growths on the sinuses), in eosinophilic esophagitis (EoE), and for prurigo nodularis.
• It is an injectable interleukin-4 receptor (IL-4) alpha antagonist that blocks receptors in the body to help lower inflammation that can lead to symptoms.
• Dupixent comes as an injection that is given by syringe or pen. Patients can be taught to use it at home by self-injection for adults and adolescents 12 years and older (with adult supervision). Children younger than 12 should receive their injection from an adult caregiver using the prefilled syringe.

This is not all the information you need to know about Dupixent for safe and effective use. Review the full Dupixent product information here, and discuss this information with your doctor or other health care provider.