Characteristics Of Ocular Adverse Reactions
Patients with atopic dermatitis commonly present with ocular surface diseases such as allergic conjunctivitis, blepharitis, and keratitis, as well as infectious conjunctivitis and keratoconus .
The mechanisms by which dupilumab or tralokinumab increase the occurrence of, or exacerbate, ocular adverse events are not fully understood.
Publications, including individual case reports about patients experiencing suspected ocular side effects with dupilumab, show variability in timing of onset and progression, presentation, and sequelae of ocular adverse reactions. In most reports received by the MHRA where patients have experienced ocular adverse reactions with dupilumab, the reactions have not been considered to be serious by the reporter. However, the MHRA has received 9 reports of 5 patients who experienced ulcerative keratitis with dupilumab, and, where the information was provided, treatment required corneal gluing or tectonic keratoplasty. The details of some of the serious reports, and expert advice, indicate that early review and intervention are beneficial to the patient.
Expert ophthalmology and dermatology advice provided to the MHRA indicated that in the UK clinical experience, most ocular reactions seen with dupilumab are mild and can be managed. However, it is not currently possible to predict who may experience the rarer and most severe ocular adverse reactions, such as ulcerative keratitis.
Dupixent Use And Random Flares On The Neck And Chest:
Random flares have been observed in patients who initially responded very well. Random flares have been observed especially in skin areas that are located around the eyes and near the face.
This is a picture of a patient who observed random flares in her symptoms after she got rid of a huge amount of eczema on her torso.
After months of using Dupixent, she started observing random flares over her neck and chest. Although, mild but still that is something to be worried about because the face and surrounding areas are very important as far as looks are concerned.
Dupixent cleared eczema but developed random flares on the chest and neck
Dupixent cleared this patients eczema but she developed random flares.
Reviews of the patient:
I need help. I need to manage this. I got rid of huge amounts of eczema on my torso within a few weeks of starting Dupixent treatment, but noticed random flares over my chest and neck.
Financial And Insurance Assistance
If you need financial support to pay for Dupixent, or if you need help understanding your insurance coverage, help is available.
Sanofi and Regeneron Pharmaceuticals Inc., the manufacturer of Dupixent, offers a MyWay Copay Card Program. This may help lower the cost of your medication if you have insurance coverage for prescription drugs.
If you dont have insurance coverage for this drug, the Dupixent MyWay Patient Assistance Program may be able to help lower the cost of your treatment. For more information and to find out if youre eligible for support, call 844-DUPIXENT or visit the program website.
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Dupixent For Chronic Rhinosinusitis With Nasal Polyps
Dupixent is approved to treat chronic rhinosinusitis with nasal polyps in adults. Its used when the condition is not well controlled by other treatments.
Dupixent is used as an add-on treatment in people with chronic rhinosinusitis with nasal polyps who are already taking another medication to treat it. Rhinosinusitis is when your sinus cavities swell and cause pain or pressure in your face, along with congestion. Rhinosinusitis becomes chronic when it lasts for 12 weeks or longer.
Nasal polyps are tissue growths in the nose that are noncancerous. People with chronic rhinosinusitis usually have an increased number of eosinophil cells in their nasal and sinus cavities. Eosinophils are immune system cells that increase swelling in the area.
Dupixent helps by reducing swelling in the area, which relieves symptoms of chronic rhinosinusitis with nasal polyps.
In clinical trials, Dupixent greatly decreased nasal and sinus symptoms caused by chronic rhinosinusitis. It also helped improve peoples sense of smell. Reduced ability to smell is a common side effect of nasal polyps.
After 24 weeks, people taking Dupixent experienced a 51% to 59% decrease in nasal congestion. In comparison, people taking a placebo experienced a 16% to 18% decrease in nasal congestion.
Controlling Side Effects And Staying On Course
Ive been on Dupixent for two-and-a-half years, and its the most effective treatment Ive ever had, said Jeffrey Lin, a 35-year-old from Los Angeles whose AD is so severe that he didnt qualify for inclusion in clinical trials.
Lin was born with every conceivable sensitivity. I have severe asthma and allergies to everything on the planet, he said. At a certain point, I couldnt even touch water. And as for my skin, I looked like a burn victim. It was as if my whole body was leaking fluids. Every pore was like an open wound.
Lin said Dupixent has improved his AD and asthma significantly. I still have allergies, he admitted, but Dupixent reduced two out of my three major health problems, which is amazing.
Lins life has been improving day by day and month by month. But he confessed to a feeling of disorientation after struggling with AD for so many years.
I grew up thinking that suffering was normal, he said. Its actually a bit disorienting to feel better. Its kind of like a phantom limb feeling. What should I do with my hand if Im not using it to scratch?
Like Greenspun, Lin has had eye problems that come and go. Steroid eye drops have helped, but his dermatologist found an additional way to deal with the side effect.
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Before Taking This Medicine
You should not use Dupixent if you are allergic to dupilumab.
Dupixent should not be given to a child younger than 6 months of age to treat eczema, younger than 6 years of age to treat asthma, under 12 years of age and weighing at least 88 pounds to treat eosinophilic esophagitis, or younger than 18 years of age to treat chronic rhinosinusitis with nasal polyposis or prurigo nodularis.
To make sure Dupixent is safe for you, tell your doctor if you have:
a parasite infection or
if you are scheduled to receive any vaccine.
If you use Dupixent to treat eczema or chronic rhinosinusitis with nasal polyposis, tell your doctor if you also have asthma.
Tell your doctor if you are pregnant or breastfeeding.
If you are pregnant, your name may be listed on a pregnancy registry to track the effects of dupilumab on the baby.
Treatment Pathways And Uk Expert Consensus For Ocular Adverse Reactions
UK clinical experience is that dupilumab treatment does not usually need to be discontinued in the event of ocular reactions. It is important for the patient to receive timely advice and intervention with appropriate care and management of ocular reactions, and for patients and healthcare professionals to recognise serious reactions, and when ophthalmological referral is necessary.
Consult local treatment pathways to outline the spectrum of differential diagnoses that should be considered and the monitoring and treatment of patients who experience ocular side effects while treated with dupilumab. A UK expert consensus-based guidance on the management of people with dupilumab-related ocular surface disorders is currently being developed by relevant national specialty organisations.
Refer to these guidelines and local treatment pathways to guide management of dupilumab or tralokinumab associated adverse ocular reactions. Prompt referral for ophthalmological examination should be made where appropriate.
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Can Fasenra Be Used For Eosinophilic Esophagitis
Fasenra is currently approved as an add-on maintenance treatment for severe eosinophilic asthma in the US, EU, Japan and other countries,13 and is approved for self-administration in the US,14 EU15 and other countries. Fasenra is in development for other eosinophilic diseases and chronic obstructive pulmonary disease.
Is Dupixent Used To Treat Cancer Dyshidrotic Eczema Alopecia Or Psoriasis
But its possible that healthcare professionals may prescribe this drug off-label for other conditions.
If you have questions about Dupixents effectiveness for other conditions, talk with your doctor.
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Who Is Dupilumab For
DupiIumab is licensed for the treatment of adults and children aged 12-17 with moderate to severe eczema and children with severe eczema aged 6-11, who are possible candidates for systemic therapy. It is unlikely that anyone whose eczema is not at the severe end of the spectrum will be considered for dupilumab. To be eligible for dupilumab you will usually need to have tried at least one immunosuppressive drug and the drug needs to have not worked effectively for you. You may also be eligible for dupilumab if you have been found to be ineligible for immunosuppressive drugs for example, if it is known that your body will not tolerate them. Dupilumab is significantly more expensive than other drugs currently available for eczema, which might make it more difficult to access.
Administration Of Dupixent In Eczema
Dupixent is given by injection subcutaneously. Syringes of 100 mg to 300 mg come from the company and then according to the requirement, the patient is either told how to inject it or is administered by some professional.
While in the case of children, the supervisor must be there to prevent the damage which can be due to negligence of children.
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Facial Eczema: Before Treatment Picture And After Six Months Of Dupixent:
As mentioned earlier, the face is one of the most difficult to treat areas. More importantly, you can not hide it. It is associated with so much stigma if you have a diseased face compared to the rest of your body.
A slight improvement in facial appearance is linked with so much confidence and energy. Hence, I selected this picture of a patient who was successfully treated with Dupixent.
Here are the pictures after six months of Dupixent injection use:
Facial eczema cleared with Dupixent use after 6 months
Dupixent worked like a miracle. This picture is taken after six months of Dupilumab injection.
Dupixent Reviews of the patient:
Dupixent has been a game-changer for me. I am so thankful
This is incredible. I finally feel like myself
Could I Take Dupilumab While Breastfeeding Or Pregnant
It is best to avoid taking dupilumab while breastfeeding. There is currently only limited research data on the use of dupilumab by pregnant women. Dupilumab should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is important to speak to your dermatologist about your specific situation.
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Dupixent Reviews: Eczema Of The Arms Cleared After Only Three Shots
Although Dupixent may take up to 16 weeks, the time to reach a steady-state concentration, some patients notice improvement after the first few shots.
This is a review of a patient who noticed a marked improvement in the symptoms of his arm and forearm eczema.
This patient had a rapid improvement in his eczema. He noticed improvement only after three shots of Dupixent injection.
Is Dupilumab Available On The Nhs
Dupilumab has been approved by the National Institute for Health and Care Excellence for routine use by the NHS in England and Wales, and by the Scottish Medicines Consortium for NHS use in Scotland. The healthcare system in Northern Ireland usually implements NICE guidance. Initially approved for treating eligible adults with moderate to severe atopic eczema, dupilumab is now also available on NHS prescription to treat children with more severe atopic eczema aged 6 years and above.
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We Asked You Answered
We recently asked our community members on social media to share their experiences with Dupixent. Heres what you said:
Dupixent cleared up my pain and other AD symptoms almost instantly. I had the starter dose administered before going to bed, and I woke up six hours later to find that I was pain-free with my stubborn AD skin patches gone. Morgan Brunson, Tinton Falls, New Jersey
My eyes are a little itchy and gunky, but I would choose that side effect in a heartbeat rather than go back to the way things were before starting the treatment. All I can say is, I dont know if I would be here today without Dupixent. It saved my life. Emily Coffman-Peerson, Richmond, Virginia
Within two to three months of my first dose of Dupixent, I felt myself becoming the old Lisa-Marie feeling social and allowing myself to find romance again after feeling like no man would ever put his hands on my skin. Lisa-Marie Freire, New York, New York
Is my skin better since starting on Dupixent? Yes. Is it hit-or-miss? Yes. Do I feel like poo for several days, but my skin still looks okay? Yes. Have I figured out a pattern? No. I never know how I will feel from one day to another. Melissa Hornick, Conway, Arkansas
I am eternally grateful to the team of scientists and doctors who made Dupixent possible. Eczema warriors are finally being heard, and our cries for help are being answered. Dara Korn, Los Gatos, California
What Is The Mechanism Of Action For Dupixent
Dupixent, an injectable interleukin-4 receptor alpha antagonist from Regeneron, was first approved by the FDA in March 2017. Dupixent also inhibits interleukin-13 by binding to a receptor shared by the IL-4 and IL-13 receptor complexes. Dupixent blocks the action of IL-4 signaling via the Type I receptor and both IL-4 and IL-13 signaling through the Type II receptor.
Many different types of cells and compounds that cause inflammation express the IL-4R subunit. Examples include mast cells, eosinophils, histamine, cytokines, leukotrienes and others. It is thought that blocking IL-4R with Dupixent inhibits the inflammatory response from these compounds.
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Biologics Xolair Nucala Fasenra And Dupixent
For many years, treatment for allergic conditions and asthma included avoidance, implementation of environmental controls, use of antihistamines and anti-inflammatory medications and subcutaneous or sublingual immunotherapy. However, in recent years, several biologic therapies have been developed, targeting specific receptors within the immune system that contribute to chronic inflammatory diseases such as asthma and atopic dermatitis, and thus preventing the cycle of inflammation in the first place. In addition, biologics take an inside out approach to treating inflammatory conditions by addressing the issue at the immune system level, the root cause of many diseases. Studies have shown that these medications can help to prevent severe asthma attacks often leading to emergency room visits, reduce the use of oral steroids, increase ones level of activity and most importantly, increase ones quality of life.
Pbs Listings Of Dupixent For Uncontrolled Severe Asthma And Severe Atopic Dermatitis
Dupixent is now listed on the Pharmaceutical Benefits Scheme in Australia for the treatment of patients aged 12 years and older with:
- Uncontrolled severe asthma from 1st April 2021 and
- Severe atopic dermatitis who have failed to respond to optimally prescribed topical treatments from 1st March 2021.
Dupixent is a fully human monoclonal antibody that inhibits the signaling of the interleukin-4 and interleukin-13 pathways. IL-4 and IL-13 are key and central drivers of type 2 inflammation that plays a central role in allergic and eosinophilic asthma, as well as atopic dermatitis. Dupixent is not an immunosuppressant.
Dupixent is jointly developed by Sanofi and Regeneron under a global collaboration agreement.
Full Product Information is available from Sanofi-Aventis Australia Pty Ltd at www.guildlink.com.au/gc/ws/sw/pi.cfm?product=swpdupix or by contacting 1800 818 806.
Consumer Medicine Information is available at www.guildlink.com.au/gc/ws/sw/cmi.cfm?product=swcdupix
Further information is available here:
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Uva Researchers Find Medicine For Asthma And Eczema Helps Covid Patients
A medication used to treat asthma and eczema can improve survival rates for patients with moderate to severe COVID-19, a clinical trial conducted at UVA Health suggests.
UVA is the first to test this novel and promising approach to COVID-19 treatment. The study centered on a monoclonal antibody called dupilumab, most often prescribed for skin conditions, asthma, and sinus congestion and swelling. The treatment also proved safe in the small study, as expected, because dupilumab is already a safe and effective allergy medicine.
The small trial, designed and led by Dr. Jennifer Sasson, found that dupilumab improved patient survival at 60 days and reduced the number of patients who needed intensive care. Almost 90% of patients who received dupilumab in the randomized trial were alive at 60 days, compared with 76% of patients who did not.
Our clinical trial suggests that treatment with the anti-allergy medicine dupilumab may decrease deaths due to COVID-19, said Sasson, of the University of Virginia School of Medicines Division of Infectious Diseases and International Health. A large multi-institution study to validate these preliminary results is being designed. If successful, this multi-site trial will open a new window to treatment of COVID-19 and potentially other viral pneumonias.
How Long Does It Take To Work
Dupixent begins to work after the first injection. However, it may take a few weeks before you notice an improvement in symptoms.
In a clinical study, more than 36% of adults with eczema had relief from itching in 16 weeks or less while taking Dupixent. In children ages 12 to 17 years old, 37% had itching relief in 16 weeks.
You should continue treatment for at least 16 weeks to determine if Dupixent works for you. If your eczema, asthma, or chronic rhinosinusitis with nasal polyps isnt responding or improving after 16 weeks, talk with your doctor. You can discuss whether you should keep taking Dupixent or switch to another treatment.
Here are answers to some frequently asked questions about Dupixent.
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Dyshidrotic Eczema Cleared With Dupixent:
Dyshidrotic eczema or pompholyx is basically eczema of the palms and soles. Since the skin of the palms and soles is very thick, it is difficult to treat using topical corticosteroids.
Dupixent injection has helped this patient change his hand appearance significantly. he stated that his hand eczema cleared after struggling for 17 years and he had lost all hopes.
Dupixent changed my life. I look back at my life and want to cry some days. I have had dyshidrotic eczema involving my hands for about 17 years and I never thought my hands would look normal again