Dupilumab (Dupixent)
Antiasthma | Dermatological Agent
Dupixent (dupilumab) is classified as a monoclonal antibody used primarily in the treatment of moderate-to-severe atopic dermatitis, asthma, and chronic rhinosinusitis with nasal polyposis.
Indications and Use:
- Approved for the treatment of moderate-to-severe atopic dermatitis in patients who are candidates for systemic therapy or phototherapy.
- Also used in adults and certain pediatric populations for the management of moderate-to-severe asthma that is eosinophilic or steroid dependent.
- Effective in treating adult patients with chronic rhinosinusitis with nasal polyposis when other treatments are not sufficient.
Mechanism of Action:
- Dupixent works by inhibiting the signaling of interleukin-4 (IL-4) and interleukin-13 (IL-13), two key proteins that play a significant role in inflammation and are believed to be critical drivers of the pathogenesis of asthma, allergies, and atopic dermatitis.
Administration Guidelines:
- Administered via subcutaneous injection. It is important to train patients properly on self-administration techniques to ensure adherence and minimize injury.
- Routine rotation of injection sites is advised to prevent the development of local site reactions.
- No premedication is required.
- Dupilumab prefilled syringes should be stored in the refrigerator at 2°C to 8°C (36°F to 46°F). Do not freeze. Keep the product in the original carton to protect from light until the time of use. Once removed from the refrigerator, it must be used within 14 days and stored at room temperature.
Dosing Flexibility:
- Dupixent allows some flexibility in dosing regimens depending on the condition being treated and its severity. Regular monitoring and dosage adjustments based on therapeutic response and patient tolerance are crucial.
Side Effects:
- Common side effects include injection site reactions, eye and eyelid inflammation, including conjunctivitis, keratitis, and dry eyes. Inform patients about these potential risks and manage them proactively.
- Rarer but severe side effects might include hypersensitivity reactions. Patients should be advised to seek immediate medical help if symptoms of allergic reactions occur.
Monitoring Parameters:
- Regular monitoring of symptoms and lung function in asthma or respiratory conditions.
- Assess skin condition improvements and check for signs of infection in patients with atopic dermatitis.
- Eye examinations should be considered if new or worsening eye symptoms occur.
Contraindications and Precautions:
- Precaution is necessary in patients with helminth infections; Dupixent may alter the immune response to these infections.
- Not recommended for use during acute asthma episodes or to treat other acute breathing problems.
- Comprehensive patient history should be evaluated to understand the potential risk of helminth infection before starting therapy.
Patient Education:
- Patients should be educated on the chronic nature of their conditions and the role of Dupixent in managing their symptoms, not curing the disease.
- Emphasize adherence to treatment and consultation schedules to prevent exacerbations or complications.
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