It has been a long time since there’s been a new truly major advancement in the care of childhood and adult eczema, also known as atopic dermatitis. Dupilumab (brand name Dupixent) is a monoclonal antibody created to treat atopic dermatitis.
Antibodies are also called immunoglobulins. These proteins are made by the immune system to deal with abnormal cells or infections (like bacteria and viruses) by neutralizing them or marking them for destruction. However, scientists have been able create antibodies that are specifically engineered to bind to and neutralize specific substances in the body in order to achieve a desired goal.
In the case of atopic dermatitis, that goal is binding chemical messengers in the body, which belong to a family of proteins named interleukins. Interleukin 4 and interleukin 13 (IL 4 and IL 13) are responsible for stimulating a type of white blood cell to make the chemicals that cause the inflammation and itching seen in atopic eczema.
By blocking IL 4 and IL 13, dupilumab ultimately prevents the production of other inflammatory mediators that cause eczema. The medication comes in a syringe that you inject into your skin every other week. The itching and rash of atopic eczema are significantly decreased, and most adult patients with moderate to severe eczema report a dramatic Improvement in their disease after receiving dupilumab.
The drug is generally well tolerated. The most common side effects are mild discomfort at the injection site, or eye irritation and inflammation. Some patients need to see an eye doctor for eye lubricants and other medications to help deal with the eye inflammation. The medication does not seem to suppress the immune system. Although there is a small increase in herpes infections, it appears that other infections are actually decreased in patients receiving dupilumab. A small percentage of patients experience upper respiratory tract infection symptoms.
Patients with moderate to severe atopic dermatitis that is poorly controlled with creams alone can rejoice since there is a new well tolerated medication that can dramatically improve their skin disease and need only be administered once every two weeks. At this time, the medication is approved only for adults, but studies are in progress to determine the best dosing and safety strategies for children. Stay tuned for more information!