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DUPIXENT has a unique mechanism of action in asthma. It is the first and only dual inhibitor of IL-4 and IL-13 signaling, inhibiting two key sources of Type 2 inflammation in asthma. IL-4 and IL-13 signaling impact Type 2 inflammation both locally and systemically. DUPIXENT is not an immunosuppressant. The mechanism of dupilumab action in asthma has not been definitively established.1-3Watch a video on how
DUPIXENT is indicated as an add‑on maintenance treatment of adult and pediatric patients aged 6 years and older with moderate‑to‑severe asthma characterized by an eosinophilic phenotype or with oral corticosteroid dependent asthma. Limitation of Use: DUPIXENT is not indicated for the relief of acute bronchospasm or status asthmaticus.1See EXAMPLES OF APPROPRIATE PATIENT TYPES FOR DUPIXENT
Type 2 inflammation is present in up to 84% of adult asthma patients and can be both local and systemic. DUPIXENT targets both IL-4 and IL-13 signaling, inhibiting two key sources of Type 2 inflammation in asthma. The mechanism of dupilumab action in asthma has not been definitively established.1-5
DUPIXENT is indicated as an add-on maintenance treatment of adult and pediatric patients aged 6 years and older with moderate-to-severe asthma characterized by an eosinophilic phenotype or with oral corticosteroid dependent asthma. Limitation of Use: DUPIXENT is not indicated for the relief of acute bronchospasm or status asthmaticus.1Learn more about patients who may be affected by Type 2 inflammation
DUPIXENT is the first and only dual inhibitor of IL-4 and IL-13 signaling. It is the only biologic indicated for OCS‑dependent asthma patients. The mechanism of dupilumab action in asthma has not been definitively established.1WATCH A VIDEO ON THE UNIQUE MOA OF DUPIXENT
Yes. DUPIXENT treatment decreased FeNO (up to 35% reduction from baseline by Week 2a) and circulating concentrations of eotaxin-3, total IgE (up to 83% reduction from baseline at Week 96b), allergen-specific IgE, TARC, and periostin in asthma subjects relative to placebo. DUPIXENT decreased these markers of Type 2 inflammation and sustained the effects throughout treatment. In addition, there was an impact on eosinophil activation and trafficking (up to 35% median percent reduction from baseline at Week 96b). The mechanism of dupilumab action in asthma has not been definitively established.1,6‑11
b TRAVERSE OLE.
In addition to moderate-to-severe asthma, DUPIXENT is indicated in 2 other disease states.1LEARN MORE
DUPIXENT offers rapid breathing relief patients can feel as early as Week 2. Approximately 72% of the total FEV1 improvement (470 mL improvement at Week 52 compared to baseline FEV1 of 1.78 L) was seen at Week 2 in patients in QUEST with baseline blood EOS ≥300 cells/μL taking DUPIXENT 200 mg + SOC (n=264) (secondary endpoint).1,12
320 mL improvement from baseline in pre-bronchodilator FEV1 at Week 12 with DUPIXENT 200 mg + SOC (n=631) vs 180 mL with placebo + SOC (n=317) (LSM difference: 140 mL [95% CI: 80, 190 mL]) (QUEST, ITT population, primary endpoint).1
In QUEST, a significant difference from placebo + SOC was not observed at 12 weeks in change in pre-bronchodilator FEV1 in patients with baseline blood EOS ≥150 to <300 cells/μL taking DUPIXENT 300 mg + SOC and in patients with baseline blood EOS <150 cells/μL taking DUPIXENT 200 mg or 300 mg + SOC.1
Patients with baseline blood EOS ≥300 cells/μL in QUEST experienced sustained breathing relief at Week 52: a 470 mL improvement from baseline in pre-bronchodilator FEV1 with DUPIXENT 200 mg + SOC (n=264) vs 170 mL with placebo + SOC (n=148) (secondary endpoint).1,12
DUPIXENT reduced severe exacerbations by up to 81% in subjects with EOS ≥300 cells/μL with DUPIXENT 300 mg + SOC (n=64) vs placebo + SOC (n=68) (0.20 vs 1.04; rate ratio: 0.19 [95% CI: 0.07, 0.56]) (secondary endpoint) in DRI12544.
In addition, DUPIXENT demonstrated a 60% reduction in severe exacerbations in subjects with EOS ≥150 cells/µL with DUPIXENT 300 mg + SOC (n=452) vs placebo + SOC (n=237) (rate ratio: 0.40 [95% CI: 0.31, 0.53]) (secondary endpoint) in QUEST.
DUPIXENT also reduced severe exacerbations by 46% in patients with no biomarker requirement (ITT population) with DUPIXENT 300 mg + SOC (n=633) vs placebo + SOC (n=321) (rate ratio: 0.54 [95% CI: 0.43, 0.68]) (primary endpoint) in QUEST.
No statistically significant differences were observed during the 52-week treatment period in patients with baseline blood EOS <150 cells/μL taking DUPIXENT 200 mg or 300 mg + SOC and in the ≥150 to <300 cells/μL EOS subgroup treated with DUPIXENT 200 mg + SOC vs matching placebo + SOC in QUEST.1,10View the exacerbation data
In VENTURE in the ITT population, 86% of OCS-dependent asthma patients reduced or eliminated their OCS dose at Week 24 with DUPIXENT 300 mg + SOC (n=103) vs 68% with placebo + SOC (n=107). Overall, more than half of patients receiving DUPIXENT 300 mg + SOC (n=103) in the ITT population in VENTURE completely eliminated their OCS use at Week 24 vs 29% with placebo + SOC (n=107) (secondary endpoints).
70% significant reduction in OCS dose (median 100%) from baseline at Week 24 with DUPIXENT 300 mg + SOC (n=103) (95% CI: 60%, 80%) vs 42% (median 50%) with placebo + SOC (n=107) (primary endpoint).1,13
DUPIXENT simultaneously improved asthma control (ie, reducing severe exacerbations, improving lung function) while reducing or eliminating steroid use in the ITT population at Week 24 (VENTURE, no biomarker requirement, secondary endpoints).
The most common adverse reactions from the DUPIXENT asthma trials were injection site reactions, oropharyngeal pain, and eosinophilia. These adverse reactions occurred in ≥1% of patients receiving DUPIXENT + SOC and at a higher rate than in patients receiving placebo + SOC in DRI12544 and QUEST (6-month safety pool).1
Subjects enrolled in DRI12544 and QUEST were required to have a history of at least 1 severe asthma exacerbation in the year prior to trial entry. A severe asthma exacerbation was defined as deterioration of asthma requiring the use of systemic corticosteroids for at least 3 days or asthma-related hospitalization or emergency department visit requiring systemic corticosteroids.1
Subjects enrolled in DRI12544 and QUEST were receiving the SOC for their moderate-to-severe asthma. Those enrolled in VENTURE required dependence on daily OCS in addition to regular use of high-dose ICS plus a minimum of 1 and up to 2 additional controller medications as SOC for their asthma. In all 3 trials, enrollment was unrestricted by minimum baseline blood eosinophil count. In QUEST and VENTURE, subjects with screening blood eosinophil levels >1500 cells/μL (<1.3%) were excluded.1,13
Subjects enrolled in the 52-week pediatric trial were pediatric patients (6-11 years), with uncontrolled moderate-to-severe asthma on an SOC of medium-dose ICS with a second controller or high-dose ICS with or without a second controller. Patients were evaluated in 2 prespecified populations: blood EOS ≥300 cells/μL and blood EOS ≥150 cells/μL or FeNO ≥20 ppb.14View the full study designs View the full study DESIGN FOR PEDIATRIC PATIENTS (6-11 YEARS)
DUPIXENT is an injectable medicine that is administered by subcutaneous injection. DUPIXENT is intended for use under the guidance of a healthcare provider. However, patients 12 years of age and older may self‑inject DUPIXENT after receiving training in subcutaneous injection technique using the pre‑filled syringe or pen. In pediatric patients 12 years of age and older, it is recommended that DUPIXENT be administered under the supervision of an adult. The DUPIXENT pre‑filled syringe should be given by a caregiver in pediatric patients (6‑11 years).1LEARN MORE ABOUT DOSING INSTRUCTIONS, SCHEDULES, AND RECOMMENDATIONS
If your patient is 12+ years and has moderate-to-severe asthma with an eosinophilic phenotype, DUPIXENT is available in 200 mg and 300 mg doses. The 200 mg treatment, given every 2 weeks, has an initial loading dose of 400 mg (2 x 200 mg pre-filled pens or syringes), and the 300 mg treatment, given every 2 weeks, has an initial loading dose of 600 mg (2 x 300 mg pre-filled pens or syringes).1
If your patient is 12+ years and has OCS-dependent asthma or comorbid moderate-to-severe atopic dermatitis or is an adult with comorbid chronic rhinosinusitis with nasal polyposis, the recommended dose is an initial loading dose of 600 mg (2 x 300 mg pre-filled pens or syringes) followed by 300 mg given every 2 weeks.1
If your patient is aged (6-11 years) with uncontrolled asthma for which DUPIXENT is indicated, the dosing is weight-based. For pediatric patients 15 kg to less than 30 kg,c the recommended dose is 100 mg given every 2 weeks or 300 mg given every 4 weeks via pre-filled syringe. For pediatric patients 30 kg or more,d the recommended dose is 200 mg given every 2 weeks via pre-filled syringe. For pediatric patients (6-11 years) with asthma and comorbid moderate-to-severe atopic dermatitis, follow the recommended dosage for atopic dermatitis, which includes an initial loading dose.1
c 15 kg is equal to 33 lb
d 30 kg is equal to 66 lb.
Consider completing all age-appropriate vaccinations as recommended by current immunization guidelines prior to initiating treatment with DUPIXENT. You should avoid the use of live vaccines in patients being treated with DUPIXENT. It is unknown if administration of live vaccines during DUPIXENT treatment will impact the efficacy or safety of these vaccines.
Immune responses to non-live vaccines were assessed in a study in which adult subjects with atopic dermatitis were treated once weekly for 16 weeks with 300 mg of dupilumab (twice the recommended dosing frequency). After 12 weeks of DUPIXENT administration, subjects were vaccinated with a Tdap vaccine (Adacel®) and a meningococcal polysaccharide vaccine (Menomune®). Antibody responses to tetanus toxoid and serogroup C meningococcal polysaccharide were assessed 4 weeks later. Antibody responses to both tetanus vaccine and meningococcal polysaccharide vaccine were similar in dupilumab-treated and placebo-treated subjects. Immune responses to the other active components of the Adacel and Menomune vaccines were not assessed.1
The pre-filled syringe and the pre-filled pen each come with their own set of specific instructions and guidelines for administration. After choosing your preferred method of treatment, it is important to provide proper training to patients and/or caregivers on the preparation and administration of DUPIXENT prior to use to ensure each step is followed correctly. In pediatric patients 12 years of age and older, it is recommended that DUPIXENT be administered under the supervision of an adult.1
In pediatric patients (6-11 years), a caregiver may inject a child with DUPIXENT after training in subcutaneous injection technique using the pre-filled syringe. Provide proper training to caregivers on the preparation and administration of DUPIXENT prior to use according to the Instructions for Use.1
Advise patients to follow sharps disposal recommendations after administration of DUPIXENT. Patients and/or caregivers should read the appropriate Instructions for Use prior to injecting.1
Download the full Instructions for Use below.Pre-filled Pen Instructions for Use – 200 mg
If a dose is missed, instruct the patient to administer the injection within 7 days from the missed dose and then resume the patient’s original schedule. If the missed dose is not administered within 7 days, instruct the patient to wait until the next dose on the original schedule.1LEARN MORE ABOUT DOSING INSTRUCTIONS, SCHEDULES, AND RECOMMENDATIONS
DUPIXENT should be refrigerated at 36 °F to 46 °F (2 °C to 8 °C) in the original carton to protect from light. However, before DUPIXENT is injected, it must be removed from the refrigerator and allowed to reach room temperature without removing the needle cap.
DUPIXENT MyWay is a patient support program that can help enable access to DUPIXENT through benefits verification and assistance navigating the insurance process. It also offers financial assistance for eligible patients, one-on-one nursing support, and more.LEARN MORE ABOUT THE SUPPORT OFFERED BY DUPIXENT MyWay
When filling out the DUPIXENT MyWay Enrollment Form, both you and your patient will be required to supply information, such as the patient’s insurance, diagnosis, and prescription. You can email or print the enrollment forms below.
|English Enrollment Form|
|Spanish Enrollment Form|
|FOR ENT SPECIALISTS/PULMONOLOGISTS|
|English Enrollment Form|
|Spanish Enrollment Form|
Overall, ~98% of commercially insured patients nationally are covered for DUPIXENT (MMIT Lives as of November 2021). Coverage varies by type and plan.15
With the DUPIXENT formulary status tool, you can see which insurance plans offer coverage for DUPIXENT in your area. Contact the health plan or DUPIXENT MyWay to verify coverage for a specific patient.USE THE DUPIXENT FORMULARY STATUS TOOL
Patients may be eligible for the DUPIXENT MyWay Copay Card if:
Eligible patients covered by commercial health insurance may pay as little as a $0e copay per fill of DUPIXENT (maximum of $13,000 per patient per calendar year).
EOS, eosinophils; FeNO, fractional exhaled nitric oxide; FEV1, forced expiratory volume in 1 second; ICS, inhaled corticosteroid; ITT, intention-to-treat; LSM, least squares mean; OCS, oral corticosteroid; SOC, standard of care; TARC, thymus and activation-regulated chemokine.
Information and Indications
CONTRAINDICATION: DUPIXENT is contraindicated in patients with known hypersensitivity to dupilumab or any of its excipients.
WARNINGS AND PRECAUTIONS
Hypersensitivity: Hypersensitivity reactions, including anaphylaxis, serum sickness or serum sickness-like reactions, angioedema, generalized urticaria, rash, erythema nodosum, and erythema multiforme have been reported. If a clinically significant hypersensitivity reaction occurs, institute appropriate therapy and discontinue DUPIXENT.
Conjunctivitis and Keratitis: Conjunctivitis and keratitis occurred more frequently in atopic dermatitis subjects who received DUPIXENT compared to those who received placebo, with conjunctivitis being the most frequently reported eye disorder. Conjunctivitis also occurred more frequently in chronic rhinosinusitis with nasal polyposis subjects who received DUPIXENT compared to those who received placebo. Conjunctivitis and keratitis have been reported with DUPIXENT in postmarketing settings, predominantly in atopic dermatitis patients. Some patients reported visual disturbances (e.g. blurred vision) associated with conjunctivitis or keratitis. Advise patients to report new onset or worsening eye symptoms to their healthcare provider. Consider ophthalmological examination for patients who develop conjunctivitis that does not resolve following standard treatment or signs and symptoms suggestive of keratitis, as appropriate.
Eosinophilic Conditions: Patients being treated for asthma may present with serious systemic eosinophilia sometimes presenting with clinical features of eosinophilic pneumonia or vasculitis consistent with eosinophilic granulomatosis with polyangiitis (EGPA), conditions which are often treated with systemic corticosteroid therapy. These events may be associated with the reduction of oral corticosteroid therapy. Healthcare providers should be alert to vasculitic rash, worsening pulmonary symptoms, cardiac complications, and/or neuropathy presenting in their patients with eosinophilia. Cases of eosinophilic pneumonia were reported in adult subjects who participated in the asthma development program and cases of vasculitis consistent with EGPA have been reported with DUPIXENT in adult subjects who participated in the asthma development program as well as in adult subjects with co-morbid asthma in the CRSwNP development program. A causal association between DUPIXENT and these conditions has not been established.
Acute Asthma Symptoms or Deteriorating Disease: Do not use DUPIXENT to treat acute asthma symptoms, acute exacerbations, acute bronchospasm or status asthmaticus. Patients should seek medical advice if their asthma remains uncontrolled or worsens after initiation of DUPIXENT.
Risk Associated with Abrupt Reduction of Corticosteroid Dosage: Do not discontinue systemic, topical, or inhaled corticosteroids abruptly upon initiation of DUPIXENT. Reductions in corticosteroid dose, if appropriate, should be gradual and performed under the direct supervision of a healthcare provider. Reduction in corticosteroid dose may be associated with systemic withdrawal symptoms and/or unmask conditions previously suppressed by systemic corticosteroid therapy.
Patients with Co-morbid Asthma: Advise patients with atopic dermatitis or CRSwNP who have co-morbid asthma not to adjust or stop their asthma treatments without consultation with their physicians.
Arthralgia: Arthralgia has been reported with the use of DUPIXENT with some patients reporting gait disturbances or decreased mobility associated with joint symptoms; some cases resulted in hospitalization. Advise patients to report new onset or worsening joint symptoms. If symptoms persist or worsen, consider rheumatological evaluation and/or discontinuation of DUPIXENT.
Parasitic (Helminth) Infections: It is unknown if DUPIXENT will influence the immune response against helminth infections. Treat patients with pre-existing helminth infections before initiating therapy with DUPIXENT. If patients become infected while receiving treatment with DUPIXENT and do not respond to anti-helminth treatment, discontinue treatment with DUPIXENT until the infection resolves. Helminth infections (5 cases of enterobiasis and 1 case of ascariasis) were reported in pediatric patients 6 to 11 years old in the pediatric asthma development program.
Vaccinations: Consider completing all age-appropriate vaccinations as recommended by current immunization guidelines prior to initiating DUPIXENT. Avoid use of live vaccines in patients treated with DUPIXENT.
USE IN SPECIFIC POPULATIONS
Please see accompanying full Prescribing Information.
Asthma: DUPIXENT is indicated as an add-on maintenance treatment of adult and pediatric patients aged 6 years and older with moderate-to-severe asthma characterized by an eosinophilic phenotype or with oral corticosteroid dependent asthma. Limitation of Use: DUPIXENT is not indicated for the relief of acute bronchospasm or status asthmaticus.
Chronic rhinosinusitis with nasal polyposis (CRSwNP): DUPIXENT is indicated as an add-on maintenance treatment in adult patients with inadequately controlled CRSwNP.
Atopic Dermatitis: DUPIXENT is indicated for the treatment of adult and pediatric patients aged 6 years and older with moderate-to-severe atopic dermatitis whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable. DUPIXENT can be used with or without topical corticosteroids.