Product Theater – DUPIXENT (dupilumab): Now Approved for an Extended Indication

Featuring Adam Friedman, MD, FAAD

Dr. Adam Friedman returned for the afternoon product theater to discuss atopic dermatitis (AD) and treatment with Dupixent. Dupixent is a treatment for moderate to severe atopic dermatitis in patients 12 years of age or older whose disease is not adequately controlled with topical prescription therapies. Dr. Friedman reports “atopic dermatitis is a diagnosis of clinical acumen”. It is a common systemic immune mediated chronic inflammatory disease. Up to 10% of the US population suffer from atopic dermatitis. Essential features of atopic dermatitis include pruritis, eczema, chronic and/or relapsing features. Pruritis is the most common persistent burden for patients with the characteristic “itch-scratch cycle’. Dupixent has illustrated a dramatic decrease in pruritis in patients.

Moderate to severe atopic disease is characterized by disease exacerbations that may be difficult to manage. Dr. Friedman reviewed important features of AD which include atopy, xerosis and early age of onset. Clinical presentations of AD can include erythema, serious lesions, lichenification, papulovesicles, excoriation and papules. Presentation of AD tends to be diffuse and symmetric. Comorbidities of AD include allergic conjunctivitis, rhinitis, asthma and food allergies. Up to 50% of adolescents who present with moderate to severe disease. In adolescents, Dupixent has been found to reduce itching by 50% by week 16 of treatment.

Clinical presentations of atopic disease can include erythema, serous lesions, lichenification, papulovesicles, excoriation and papules.

Dupixent is a subcutaneous injectable medication. It is a human monoclonal antibody that inhibits IL-4 and IL-3 signaling. It is not an immunosuppressant nor a steroid treatment. Injection site reaction is the most common adverse event among patients who use Dupixent, followed by conjunctivitis. It is important to rule out keratitis in patients who present with ocular symptoms. Additionally, it is not recommended to use live vaccines in patients who are using Dupixent. Lastly, of note , unlike other biologic medications, there was no observed variance in response to Dupixent in patients among different demographic groups within weight , gender, age, race or prior immunosuppressant use.