How does Dupixent work?
Dupixent is currently indicated for patients who have atopic dermatitis, asthma and nasal polyps. Dupixent works by inhibiting IL4 and IL13 and it has improved outcomes in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). A recent study published in Allergy studied Dupixent’s local effects on type 2 inflammatory biomarkers. The study evaluated adults with bilateral nasal polyps who despite intranasal corticosteroid treatment had persistent symptoms including lack of smell.
It was a placebo controlled study and there was a significant decrease of type 2 biomarker concentrations in nasal secretions for those receiving Dupixent (dupilumab).
The results showed that patients who received the dupilumab, their nasal secretions had significant reductions in the following biomarkers.
- Eosinophil cationic protein chemokine
- Eotaxin 2
- pulmonary and activation-regulated chemokine
Reductions in local biomarkers were associated with symptom improvements and reduction in polyp mass. Effective dupilumab therapy for CRSwNP is associated with reduced type 2 inflammatory markers in nasal secretions and polyp tissues. The benefit of inhibiting IL 4 and IL 13 seems to results from reductions in type 2 inflammation.
This broad mechanism of action of Dupixent gives it an advantage over other atopic disease treatments that only target 1 cytokine or the total IgE only.
The authors of this most recent study previously demonstrated that Dupixent reduced polyp size and sense of smell in patients with CRSwNP. Now their analysis shows that Dupixent reduced multiple inflammatory biomarkers including total IgE and markers of eosinophilic inflammation, in both nasal secretions and polyp tissue.
Sinusitis Diagnosis and Management
Dupixent (dupilumab) is the first biological medication indicated for nasal polyps. There sure will be more medications approved in the future that will be approved for nasal polyps. Dupixent has a broad mechanism of action as shown here which is why it works for different atopic disease states.