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Dupilumab is an injectable prescription medication administered subcutaneously to treat severe and refractory forms of atopic dermatitis. The US Food and Drug Administration (FDA) approved the medication in April 2017 to treat moderate-to-severe, resistant, atopic dermatitis unresponsive to conventional therapy, including topical corticosteroids. Dupilumab is also used as a maintenance treatment for asthma and chronic rhinosinusitis with nasal polyposis in adults and children, in conjunction with other medications. Dupilumab is also now FDA-approved for prurigo nodularis and eosinophilic esophagitis. Non-FDA-approved indications include allergic contact dermatitis, hand dermatitis, chronic spontaneous urticaria, and alopecia areata. Extensive literature suggests the efficacy of dupilumab in treating conditions characterized by Th2-mediated inflammation. Clinical trials are currently in the pipeline to explore the potential of dupilumab in treating autoimmune blistering diseases, such as bullous pemphigoid. This activity describes dupilumab, including its mechanism of action, adverse event and safety profiles, eligible patient populations, and contraindications. It also highlights the interprofessional team's role in managing patients on dupilumab treatment. Objectives: Apply evidence-based guidelines and data to guide dupilumab treatment decisions in clinical practice. Identify the appropriate indications for dupilumab in the treatment of moderate-to-severe atopic dermatitis. Assess the treatment response and monitor for adverse effects during dupilumab therapy. Implement effective collaboration among interprofessional team members to improve outcomes and treatment efficacy for patients who might benefit from dupilumab. Access free multiple choice questions on this topic.

Dupixent has no box warning, unlike the newer topical and oral Janus kinase (JAK) inhibitors used for treating atopic dermatitis. Patients on JAK inhibitor treatment should be monitored closely for the onset of any infection. The possible emergence of serious adverse events may result from the synergistic effects of JAK inhibitors with other immunomodulating agents, such as vitamin D, which also act on the JAK-STAT pathway. No serious or frequent toxicity was reported. Clinicians must be careful when using dupilumab with substrates of CYP450, as it utilizes the same enzyme for its degradation. Rare cases of vasculitis and pneumonia are evident in patients using dupilumab and CYP450 substrates.[36]

Dupilumab is an effective and safe immunomodulating therapy for treating moderate-to-severe symptoms associated with atopic dermatitis, including itching, poor sleep quality, anxiety, and depression. Evidence from increasing trials suggests that the benefits of dupilumab far outweigh its side effects. Since no concrete literature-based evidence suggests that dupilumab is contraindicated during pregnancy or lactation, shared decision-making among healthcare team members and patients is paramount for ensuring safe and effective treatment plans. Patients should receive significant education on their treatment options, including discussing the benefits and risks to maternal and fetal health, and that patient values and preferences are considered. Consultation with an immunologist is required before initiating dupilumab for severe asthma. Moderate to severe atopic dermatitis is best managed in consultation with a dermatologist. Otorhinolaryngologist consultation is necessary for patients with chronic rhinosinusitis with nasal polyposis. Both pharmacists and nurses need easy and direct access to the prescriber so any patient concerns regarding dupilumab use can be addressed immediately. Communication among healthcare team members is pivotal to obtaining optimal therapeutic results for dupilumab use with minimal adverse events.