II. Indications
- See Asthma Monoclonal Antibody
- Moderate to severe refractory, persistent Asthma
- High Eosinophil Counts or on chronic Systemic Corticosteroids
- Other Indications
III. Background
- As of 2022, approved for use down to age 6 years for moderate to severe Eczema
- Costs $3400/month in 2022, U.S.
IV. Precautions
- Live Vaccines are best completed at least 4 weeks before starting agent
V. Mechanism
- Interleukin-4/13 Alpha Receptor Antagonist
VI. Adverse Effects
- See Asthma Monoclonal Antibody
- Eye (Conjunctivitis, Dry Eyes)
- Alopecia
- Arthralgias
- Rash
- Gastritis
- Pharyngitis (2%)
- Insomnia
- Secondary infection (Oral HSV, Helminths)
- Injection site reactions (16%)
- Eosinophilia (2%)
VII. Dosing
- Adult: 600 mg SQ once, then 300 mg SQ every 2 weeks
- Child (age 6 to 11 years)
- Weight 15 to 30 kg: 100 mg SQ every 2 weeks OR 300 mg SQ every 4 weeks
- Weight >30 kg: 200 mg SQ every 2 weeks
VIII. Resources
- Biologic Therapy in Asthma
- Dupilumab (DailyMed)
IX. References
- (2022) Comparison of Asthma Medications, Presc Lett, #381217
- (2020) Drugs for Asthma, Med Lett Drug Ther 62: 193-200
- (2022) Presc Lett 29(7): 40-1
- (2018) Biologics for Asthma, Presc Lett
- Castro (2018) N Engl J Med 378(26):2486-96 [PubMed]
- Rabe (2018) N Engl J Med 378(26): 2475-85 [PubMed]
- Narasimhan (2021) Am Fam Physician 103(5): 286-90 [PubMed]
- Raymond (2023) Am Fam Physician 107(4): 358-68 [PubMed]
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