Dupixent: How Does It Help With Asthma?

Asthma is a condition that makes it difficult for a person to breathe due to airways becoming inflamed, narrow, and swollen, producing extra mucus. Though many cases of asthma are minor, it can interfere with daily activities and/or lead to potentially life-threatening attacks.

Asthma sufferers typically experience difficulty breathing, tightness or pain in the chest, coughing, and wheezing. The condition is generally manageable with inhalers that can treat and prevent symptoms.

What is Dupixent?

Dupixent is the brand name for the biologic medication Dupilumab, used in treating asthmatic conditions. Dupilumab is the active ingredient in Dupixent. A biologic medication means that the drug is made from cells of living organisms modified to target particular molecules in humans. 

This prescription drug comes in pre-filled syringes containing a single dose. Patients receive Dupixent as an injection under their skin. Typically, you'll receive the Dupixent injection at the doctor's office, but you may administer the jab to yourself after you learn how to do it. 

Uses

Below are three common uses of Dupixent medication:

Treating certain forms of moderate to severe asthma

Dupixent is used together with one or more other drugs to help prevent asthma symptoms in adults and some children. However, Dupixent should not be used in treating sudden asthma attacks. Instead, one should use a rescue inhaler in such situations.

Treating eczema

Dupixent can treat eczema in adults and children if topical prescription medications aren't working well. A medical provider may also recommend Dupixent if medicated skin creams cannot be used. 

Treating chronic sinusitis with nasal polyps

Nasal polyps are tissue growths on the nose that can cause difficulty breathing. Medical providers may recommend Dupixent alongside other medications for adults whose symptoms are not properly managed. 

Is Dupixent safe for asthma?

Dupixent (Dupilumab) received FDA approval for asthma in patients aged 12 and above in 2018¹ and as an add-on maintenance treatment for patients between 6-11 years later in 2021. The 2021 approval was based on data obtained from the Libert Asthma Voyage² trial. 

This trial evaluated the safety and efficacy of the drug combined with standard-of-care asthma therapy in children where more than 90% of them had one or more concurrent type 2 inflammatory conditions. 

Children who received add-on Dupixent among all those who had unmanaged moderate-to-severe asthma experienced fewer asthma exacerbations and improved lung function, unlike the placebo sample. Also, the safety results from this trial were consistent with the already known Dupixent's safety profile in patients aged 12 and above with the same condition.

Therefore, Dupixent is safe for moderate to severe asthma. 

How does Dupixent work for asthma?

Dupixent works for asthma by reducing inflammation. The medication inhibits the signaling³ of two key proteins: interleukin-4 (IL-4) and interleukin-3 (IL-13). These are pro-inflammatory cytokines responsible for inducing immunological and inflammatory reactions. The resulting inflammation may lead to moderate to severe asthma.

Dupixent (Dupilumab) binds to the receptor of these proteins, thus inhibiting their signaling pathways. 

What kind of asthma can Dupixent treat?

Asthma can range from occasional and mild to severe. Conventional medications such as inhaled corticosteroids are reliable for some types of asthma. However, the response of these medications is not effective with other types, such as eosinophilic asthma. 

The new classes, including monoclonal antibodies, were introduced due to the limitations of conventional drugs. Dupixent is among the introduced monoclonal antibody medications approved to treat⁴ moderate to severe asthma for patients with oral corticosteroid-dependent asthma or with an eosinophilic phenotype.  

Effectiveness of Dupixent for asthma

Dupixent for asthma is more effective⁵ in alleviating asthma symptoms and improving the patient's ability to breathe compared to standard therapies. The medication has shown to work particularly well for those with eosinophilic asthma but is also effective in treating uncontrolled asthma, moderate-to-severe asthma, and comorbid asthma.

Effects for moderate-to-severe asthma

A trial involving 1902 patients aged 12 and above with uncontrolled asthma who received Dupilex add-on treatment revealed that the prescription drug effectively treated the condition.⁶ Dupixent provided a substantial reduction in the rate of severe exacerbations. It also improved lung function and provided symptom relief. The patients involved in this trial received Dupilumab at a 200-300 mg dose every two weeks.

How to use Dupixent for asthma

Your healthcare professional may provide a few injections and explain how you should administer Dupixent injections yourself, including the dosage and frequency. Generally, the injection sites for Dupixent are the thigh, belly, and outer upper arm. But for the belly, it should not be within two inches of the belly button. 

Also, injections on the outer upper arm should be from a caregiver. You should avoid scarred, painful, or bruised skin areas when choosing the injection site. It would be best to choose a different site whenever get a Dupixent injection. 

Dosage

Patients aged 6-11 years

The dosage depends on their weight. Children weighing 15kg and less than 30kg can take 100 mg every two weeks or 300 mg every four weeks, while those weighing 30kg and above should take 200 mg every two weeks. 

Patients aged 12 years and above

The dosage for patients aged 12 years or older can either be a first dosage of 400 mg (administered as two injections of 200 mg) followed by weekly jabs of 200 mg or a first dosage of 600 mg (administered as two injections of 300 mg) followed by weekly jabs of 300 mg. The latter is recommended for patients with corticosteroid-dependent asthma. 

Does Dupixent interact with other medications?

Drug interactions are effects that arise when you take a certain medication while you are taking or have recently had certain foods and drinks, vaccines, supplements, other medications, or other things that can affect how that drug works. 

Remember to inform your medical care provider about all the medications you take, whether they are over-the-counter or prescription types, before taking Dupixent for asthma. In addition, list any herbs, supplements, or vitamins you use so your pharmacist or healthcare provider can tell you about any likely interactions between those items and Dupixent. 

Supplements and other medications

Currently, there are no known interactions between supplements or other drugs with Dupixent. This prescription medication is a monoclonal antibody which means it's broken down into pieces inside the cells, unlike other types of medications that are broken down in the liver and thus can interact with each other. 

Live vaccines

Dupixent treats asthma by blocking certain signals within the immune system to reduce inflammation. However, the same signals are crucial for the immune system's response to certain vaccines. For instance, live vaccines consist of weakened versions of bacteria or viruses, and therefore, you should avoid live vaccines while receiving Dupixent injections.

You should speak to your medical care provider in case you require any live vaccines so they can determine the best thing to do. 

Generally, the doctor may have you wait for four weeks or more after getting any live vaccines so they can start Dupixent. Some examples of live vaccines include yellow fever, chickenpox, smallpox, and typhoid vaccines. 

However, there is no problem if you get a non-live vaccine while receiving Dupixent. Some examples of non-live vaccines include the meningococcal vaccine, Covid-19 vaccine, pneumococcal vaccines, etc. 

Side effects of Dupixent

If you receive Dupixent treatment, you may experience mild or serious side effects. 

Mild side effects

Some of the reported mild side effects include:

Injection site reactions

Injection site reactions are common side effects in patients who receive Dupixent to treat any condition. The reactions cause various symptoms, including bruising, pain, itching, redness, change in skin color, and swelling. These side effects, which usually occur with the first dose of Dupixent, are often mild and go away after a few days. 

You can avoid reactions by choosing different areas whenever you receive a Dupixent shot. Also, avoid rubbing the skin area after injection. 

Joint pain

You may also experience joint pain when you receive a Dupixent injection. This side effect is more commonly reported in people taking prescription medication to treat rhinosinusitis with nasal polyps.

Other mild side effects include:

• Mouth or throat pain

• Cold sores due to oral  herpes

• Toothache

• Inflammation in the stomach

• Difficulty sleeping

• Eye-related side effects (mild) such as conjunctivitis (pink eye), blepharitis (eyelid inflammation), dry eyes, and itchy eyes

Serious side effects 

You may also experience some serious side effects while on Dupixent treatment. These include:

Allergic reaction

One of the serious side effects you may experience when receiving Dupixient for asthma is an allergic reaction. Some symptoms of the allergic reaction include itchiness, skin rash, and swelling under the skin, especially eyelids, hands, feet, or lips. Other symptoms of allergic reactions include swelling of the mouth, throat, or tongue, which can cause difficulty breathing and short-lived warmth, redness, or deep skin color (flushing). 

Serious eye-related side effects

You may also experience keratitis, a condition that results in inflammation of the cornea. This condition requires treatment; otherwise, it may progress to cause other problems such as corneal ulcers or even eye damage. 

Some notable symptoms of eye-related side effects are red eyes, eye discharge, eye-itching, eye pain, vision changes, eye dryness, etc. Let your medical care provider know whether you have any current eye problems or wear contact lenses before starting Dupixent injections. The doctor can advise on ways to avoid the side effects or even establish whether this prescription drug is right for you. 

Eosinophilic conditions

Another serious side effect you may experience while on Dupixent treatment for asthma is eosinophilia — a condition where the number of eosinophils (a type of white blood cells) in the blood increases. The condition leads to symptoms such as worsening shortness of breath, chest pain, skin rash, fever, numbness, and tingling sensation in the legs and arms. 

When to see a doctor 

Mild side effects experienced when receiving Dupixent for asthma often go away after a short while. However, you should see a doctor if you have ongoing or bothersome symptoms. Also, you should not stop taking this prescription medication unless your medical care provider recommends it. If you experience serious side effects which seem life-threatening, you should seek emergency medical attention. 

The lowdown

Dupixent treatment can help treat moderate to severe asthma. If you are receiving this prescription drug, you may experience mild or serious side effects. Mild side effects usually go away within a few days. However, if you experience severe side effects or mild side effects that keep recurring, you should seek medical attention.