Most people with asthma are able to control their symptoms by using inhaled medicines each day. But for some people with severe asthma, inhaled medicines are not enough to keep symptoms under control. In recent years, a new group of medicines have been approved that work in a different way to manage symptoms of severe asthma. These medicines, which are injected into the body instead of inhaled, work directly on the body’s immune system to help reduce symptoms.
One of these injected medicines that may help treat symptoms in certain people with severe asthma is called Dupixent.
How Does Dupixent Work for Asthma?
Asthma is a long-term (chronic) condition of the lungs that can make it hard to breathe. The airways can get narrowed from swelling (inflammation) and because the muscles in the airways tighten up. This swelling and tightness can make the airways very irritated and sensitive. The airways can also become clogged with mucus.
People with asthma can have asthma attacks, which can include coughing, wheezing, a hard time breathing, and tightness or pain in the chest. A lot of different “triggers” can cause an asthma attack. Some examples of common triggers are:
- Infection
- Pollen
- Pet dander
- Dust mites
- Strong smells
- Smoke
- Cold air
The key to treating asthma is to reduce the amount of swelling and tightness in the lungs. This helps make it easier to breathe. It also makes the lungs less sensitive to triggers, which can reduce the number of asthma attacks.
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 reduce the swelling that happens in the lungs of people with asthma.
Can Anyone With Asthma Use It?
Most people with asthma will be able to control their symptoms by using inhaled medicines. In some cases, adding certain medicines that are taken by mouth may also help to keep asthma symptoms under control. Dupixent is reserved for people who are still having symptoms even when they are using all of the recommended inhaled and oral medicines.
For example, Dupixent may be an option for people who need to use inhaled medicines and a certain type of drug called an oral corticosteroid (such as prednisone) every day to control their symptoms. Oral corticosteroids can cause serious side effects when taken for a long time. If you are not able to stop taking an oral corticosteroid without having serious asthma symptoms, you and your health care provider may discuss using a drug like Dupixent.
Dupixent may also be an option for people who have a certain type of asthma, called eosinophilic asthma. This type of asthma can be very severe, and symptoms may be hard to control. Many people with eosinophilic asthma still have symptoms even when they are using all of the recommended inhaled medicines.
How Was It Studied for Treating Asthma?
Multiple clinical studies were done to see if Dupixent was safe and effective for treating asthma. One of these studies only included adults (18 years and older). Another study included people who were 12 years and older. In both of these studies, the average age was 48 years old. A third study only included children 6 to 11 years old, with an average age of 9. Here is some important information about these studies:
- Everyone in these studies still had breathing issues even though they were already using the highest recommended dose of inhaled long-acting medicines each day.
- Everyone in these studies had experienced at least one severe asthma attack at some point in the past year. On average, the people in these studies had about two severe attacks in the past year. A “severe” asthma attack was one that required treatment with corticosteroids and/or required a visit to the emergency room or urgent care.
- In the studies that included adults and people 12 years and older, most of the people were female (63%). In the study for children 6-11 years old, on the other hand, most people were male (about 68%). Most of the people in these studies were White (80%-90%).
- These studies measured efficacy by asking people to take a deep breath and then force as much air out of their lungs as possible. The amount of air that a person could force out of their lungs in 1 second was recorded. This measure helps to understand how well the lungs are working.
- Two studies also measured efficacy by counting the number of severe asthma attacks that happened during a full year of treatment with Dupixent.
A separate study looked at Dupixent in people who had a severe type of asthma, called corticosteroid-dependent asthma. This study included people who were 12 years and older, with an average age of 51 years. Here is some important information about this study:
- Everyone in this study was corticosteroid-dependent. This means that they were already using the highest recommended dose of inhaled medicines each day and also needed to take oral corticosteroids (such as prednisone) every day to keep their symptoms under control. People in this study were corticosteroid-dependent for at least 6 months before the study started.
- This study measured efficacy by looking at the dose of oral corticosteroids that people needed to keep their symptoms under control, after using Dupixent for 6 months.
In all of 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 keep using their inhaled medicines as prescribed throughout the study. If they had sudden trouble breathing, they were told to use their rescue inhalers.
What Benefits Were Seen in These Clinical Studies?
Breathing function. After 3 months of treatment, the people who used Dupixent were able to force more air out of their lungs than the people who used a placebo. This improvement continued after 6 months of treatment as well. This means that people who used Dupixent were able to move air through their lungs more easily.
Severe asthma attacks. Two studies, including the study in children, counted the number of severe asthma attacks that happened during a full year of treatment with Dupixent. A “severe” asthma attack meant that a person needed to take corticosteroids for at least 3 days and/or was admitted to the hospital. In both of these studies, the group of patients using Dupixent had fewer severe asthma attacks in a year than the group of patients using a placebo.
Oral corticosteroid dose. One study only included people who were corticosteroid-dependent, which means that they needed to take a corticosteroid by mouth every day to manage their symptoms. After 6 months of treatment with Dupixent, people were able to lower their daily dose of corticosteroids further than the people who were using a placebo. This means that, on average, people who used Dupixent needed a lower dose of oral corticosteroids than people who used a placebo.
How Quickly Will It Work, and How Can I Tell if It’s Working for Me?
If Dupixent is working, you should have less trouble breathing after using it for a few weeks. Over time, this might mean that you will have fewer severe asthma attacks. If you take an oral corticosteroid every day, your health care provider may be able to reduce your dose of this medication over time.
Do not stop using Dupixent or any other asthma medicines without talking to your health care provider first, even if your breathing has gotten better. You should also not lower the dose of any of your other asthma medicines without talking to your health care provider first. Your breathing and symptoms may get worse again if you stop or change any of your medicines.
Tell your health care provider if Dupixent does not seem to be making it easier to breathe after a few months. Your health care provider may increase your dose, if you’re not already at the maximum dose, or they can discuss other options for treating asthma.
Contact your health care provider right away if your breathing problems get worse or if you need to use your rescue inhaler more often than before.
How Do I Use It?
Dupixent is a liquid that is injected under the skin every 2-4 weeks. Your health care provider will decide whether you should receive it every 2 weeks or every 4 weeks, depending on your age and weight. 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 pre-filled 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 pre-filled 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.
Is There Anything I Can Do to 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, especially medicines for asthma, before you start using Dupixent.
Tell your pharmacist or other health care 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 type of medicine called a “specialty” medicine. This means that you can only get it from a specialty pharmacy, which may need to ship the medicine to you. This also means 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.
