Most people with a condition known as chronic rhinosinusitis with nasal polyps (CRSwNP) are able to control their symptoms by using medicines that are sprayed into the nose or taken by mouth. But some people with this condition are not able to manage their symptoms with these treatments. In recent years, new medicines have been approved that work in a different way to help with the symptoms of this condition. These medicines, which are injected into the body, work directly on the body’s immune system to help reduce symptoms.
One of these injected medicines that may help to treat symptoms in people with this condition is called Dupixent.
How Does Dupixent Work for Chronic Rhinosinusitis With Nasal Polyps?
Nasal polyps are small growths in the lining of the nose or in the sinuses, which are spaces near the nose. In some cases, these growths are caused by a condition called chronic rhinosinusitis. People with chronic rhinosinusitis have swelling (inflammation) in the nose and sinuses that lasts for more than 3 months. Over time, this swelling can cause polyps to form.
For many people, nasal polyps do not cause any symptoms. But in some cases, the polyps can get big enough to block the normal function of the nose and sinuses. This can cause nasal congestion, which can include a stuffy or blocked nose, a runny nose, sneezing, and loss of taste and smell. If the sinuses can’t drain the way they normally do, mucus may build up. This can lead to pain and infection
The key to treating nasal polyps that are caused by chronic rhinosinusitis is to reduce the amount of swelling in the nose and sinuses. This may help to shrink the polyps and reduce symptoms.
The active ingredient in Dupixent is a medicine called dupilumab, which works by blocking certain proteins that send immune system signals in the body (interleukin-4 and interleukin-13). Blocking these proteins helps to reduce the swelling and irritation in people with CRSwNP.
Can Anyone With This Condition Use Dupixent?
Most people with CRSwNP will be able to control their symptoms by using a type of medicine called a corticosteroid. This medicine can be sprayed directly into the nose (intranasal). But some people will still have symptoms after using an intranasal corticosteroid for a few months. These people may need to take a corticosteroid by mouth for a short period of time to help manage their symptoms. Some people may also have surgery to remove their nasal polyps.
Dupixent may be an option for people who still have a lot of symptoms even after using an intranasal corticosteroid, an oral corticosteroid, and/or having surgery.
The LIBERTY Studies
Two clinical studies were done to see if Dupixent was safe and effective for the treatment of CRSwNP. A little more than half of the people in the studies were male (60%), and the studies took place in over 10 countries. The average age was 52 years old.
Everyone in these studies still had symptoms even though they were using an intranasal corticosteroid each day. Most of the people in the study (76%) had partly or completely lost their sense of smell. To be in these studies, everyone had also tried at least one of the following to help manage their symptoms:
- Surgery on the nose or sinuses in the past 2 years
- Corticosteroids, taken by mouth, at some point in the past 2 years
In these studies, Dupixent was compared with a placebo. The people in the studies did not know whether they were receiving the drug or the placebo. People were told to continue using an intranasal corticosteroid every day during the study.
These studies measured efficacy in two ways. These measures were taken at the beginning of the study and again after 6 months.
- Measures of the size and number of nasal polyps in each person’s nose
- Self-ratings of nasal congestion symptoms
What Benefits Were Seen in These Studies?
Size of nasal polyps. After 6 months of treatment, people who used Dupixent were more likely to have fewer and smaller nasal polyps than the people who used a placebo. One study measured the polyps again after a year of treatment. People who used Dupixent still had fewer and smaller nasal polyps than the people who used a placebo after a full year.
Nasal congestion symptoms. After 6 months of treatment, people who used Dupixent had fewer symptoms of nasal congestion than the people who used a placebo. One study asked people to rate their symptoms again after a year of treatment. People who used Dupixent still had fewer symptoms of nasal congestion than the people who used a placebo after a full year.
Sense of smell. Some people with this condition are not able to smell as well, or they may lose their sense of smell completely. In these studies, most people (76%) reported having issues with their sense of smell. After 6 months of treatment, people who used Dupixent reported a stronger sense of smell, on average, than people who used a placebo.
How Do I Use It?
Dupixent is a liquid that is injected under the skin every 2 weeks. It can be injected into the thigh, stomach, or outer area of the upper arm.
The drug comes in two forms. The most common form is a prefilled device that is ready to be injected under the skin, so you do not need to learn how to use a syringe and needle. The other form is a prefilled syringe with a needle, which is most often used in very young children. In either case, your health care provider will show you how to inject the drug before you use it the first time. Read the instructions for use, which you can get from your pharmacist.
It is important to inject the drug properly so that you get the right dose. Your prescription should come with “Instructions for Use,” which explains how to prepare and give a dose. Ask your pharmacist or other health care provider if you are unsure how to use Dupixent.
How Quickly Will Dupixent Work for Chronic Rhinosinusitis With Nasal Polyps?
If Dupixent is working, you may notice some changes within the first week, such as an increase in your sense of smell. Other symptoms, such as nasal congestion, will start to improve within the next few weeks or months.
Do not stop using Dupixent or any other medicines for this condition without talking to your health care provider first, even if your symptoms have gotten better. Your symptoms may get worse again if you stop or change any of your medicines.
How Can I Prevent or Manage Side Effects?
The most common side effect seen with Dupixent is a skin reaction where you get the shot, which may involve redness, pain, swelling, and/or bruising. These reactions are most common after the first dose of Dupixent but can happen with later doses as well. The best way to decrease these reactions is to inject the drug into a different part of the body each time, which is called “rotating” the injection site. For example, Dupixent can be injected into different parts of the thigh, stomach, or outer area of the upper arms. Don’t inject the drug into skin that is already tender, damaged, bruised, or scarred.
These are not all of the possible side effects of Dupixent. Talk with your health care provider if you are having symptoms that bother you. If you experience anything that you think may be caused by Dupixent, you can also report side effects to the FDA at 800-FDA-1088 (800-332-1088).
Are There Any Interactions With Other Medicines?
It is important for your health care provider to be aware of every medicine you are taking before you start using Dupixent, especially if you are taking any medicines for asthma.
Tell your pharmacist or other healthcare provider about all the prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, or other supplements you take or have recently taken. This will help them find the best treatment plan for you.
Are There Any Interactions With Vaccines?
It is important to discuss any recent or upcoming vaccines (immunizations) with your health care provider. There are certain vaccines (“live” vaccines) that you should not receive either right before starting Dupixent or once you have already started using Dupixent. Your health care provider will confirm whether any recent or upcoming vaccines are safe.
Are There Any Special Steps Required to Get Dupixent?
Dupixent is a “specialty” medicine. This means that you can only get it from a specialty pharmacy and that it may require prior authorization from your insurance company. You can find out more about this at https://www.dupixent.com/support-savings/dupixent-my-way.
Is There a Coupon Card Available?
There is a savings coupon available from the drugmaker that may allow you to pay $0 for your prescription. Whether you are eligible depends on whether you have prescription insurance and what type of insurance you have. You can find out more at https://www.dupixent.com/support-savings/copay-card.
