When The Eczema Patient Is Also A Doctor
Vivian Shi, MD, a dermatologist on the faculty of the University of Arizona Health Sciences in Tucson, brings a unique perspective to her medical practice, teaching and research: shes an AD patient herself.
Shi spent her childhood in China, and her family emigrated to the United States when she was in her early teens. Her AD only added to her feelings of vulnerability as an immigrant.
Vivian Shi, MD
But as she matured, Shi made it her mission to become a physician and work on finding improved treatments for the condition that had haunted her for most of her life. Today, her greatest wish is to help her patients not be defined by their AD, she said.
Eye problems are concerning, Shi admitted, but her approach is to refer patients on Dupixent to an ophthalmologist the minute eye symptoms show up. And even if a patient has unwelcome side effects, Theyll usually say, Please dont take me off it! So far, I havent had to, Shi said.
Asked whether Shi is taking Dupixent herself, the answer was no. Moving to Arizona has made my AD better, she explained. I also recognize my triggers. As I often tell my patients, knowledge is power.
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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.
Dupilumab Approved In 2019
In June 2019, dupilumab was approved by the U.S. Food and Drug Administration to treat adults with nasal polyps accompanied by chronic rhinosinusitis. In the announcement of the drugs approval for this indication, Sally Seymour, MD, director of the division of pulmonary, allergy and rheumatology products in the FDAs Center for Drug Evaluation and Research, said that dupilumab provides an important treatment option for patients whose nasal polyps are not adequately controlled with intranasal steroids. It also reduces the need for nasal polyp surgery and oral steroids.
Other biologics are being studied in clinical trials for treatment of nasal polyps, including omalizumab and mepolizumab . Each targets a different inflammatory trigger . Biologics like dupilumab have already been approved for other indications, such as asthma and eczema. How do they work in patients with sinusitis and nasal polyps? Otolaryngologists have mixed views on their efficacy when compared with the conventional treatments of surgery and steroid irrigation.
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Pregnancy And Breastfeeding While Receiving Dupixent
Its not known if Dupixent is safe to use during pregnancy. Its also not known if Dupixent passes into breast milk or if it can cause side effects in a breastfed child.
If youre pregnant or planning to become pregnant, talk with your doctor about the possible risks and benefits of receiving Dupixent. And let them know if youre breastfeeding or planning to breastfeed.
Fda Oks 1st Drug For Sinusitis With Nasal Polyps
THURSDAY, June 27, 2019 — In what specialists say could be a turning point in care, the U.S. Food and Drug Administration on Wednesday approved the first drug to treat chronic sinusitis that involves the growth of polyps within the sinuses.
Dupixent is given by injection every two weeks. It was approved to treat patients with nasal polyps and chronic rhinosinusitis — defined as a prolonged inflammation of the sinuses and nasal cavity, the FDA said.
“Nasal polyps can lead to loss of smell and often patients require surgery to remove the polyps,” explained the FDA’s Dr. Sally Seymour in an agency news release.
“Dupixent provides an important treatment option for patients whose nasal polyps are not adequately controlled with intranasal steroids. It also reduces the need for nasal polyp surgery and oral steroids,” said Seymour. She directs the division of pulmonary, allergy and rheumatology products at the FDA’s Center for Drug Evaluation and Research.
Specialists familiar with the chronic condition applauded the drug’s approval.
“Otolaryngologists and allergists have been waiting years for this approval,” said Dr. David Hiltzik, who directs head and neck surgery at Staten Island University Hospital in New York City.
Dr. Jordan Josephson is an ear, nose and throat and sinus specialist at Lenox Hill Hospital, also in New York City. He said that early studies suggest Dupixent is “very promising as another tool in the fight against chronic sinusitis and nasal polyps.”
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What Does Dupixent Cost
Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use. To find current prices for Dupixent in your area, visit WellRx.com.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Dupixent manufacturers website to see if they have support options.
Dupixent treats these conditions by targeting a very specific part of your immune system. Read on to learn more about these conditions and how Dupixent is used for them.
Moderate to severe atopic dermatitis
Dupixent is used for eczema in adults and kids ages 6 years and older. Its prescribed when medications applied on the skin are not working well to control eczema symptoms. Its also an option to try when those drugs cant be used.
With eczema, you have dry, itchy skin patches that can flare up into rashes. Certain triggers, such as scented soaps or detergents, can cause eczema flare-ups. Eczema is a skin condition thats most common in children, but it can also continue into adulthood.
To treat eczema, Dupixent can be used alone or with corticosteroids applied to the skin.
Moderate to severe asthma
Dupixent is used as an add-on treatment for certain types of asthma in adults and children ages 12 years and older. These types of asthma include:
- increased mucus
Chronic sinusitis with nasal polyps
What Are The Side Effects
After speaking to lots of eczema sufferers who have been using this medication for the past year the most common side effects seem to be around the eyes . ;Some also complained of cold sores and sensitive areas around the mouth.
One or two people I spoke to out of APX 20 had to come off the medication due to bad swelling around the eye, most people did see a great reduction in the symptoms and greatly improved skin. However, if the side effects are too bad you will need to come off the medication no matter how much your eczema improved.
DUPIXENT can cause serious side effects, including:
- Allergic reactions. Stop using DUPIXENT and go to the nearest hospital emergency room if you get any of the following symptoms:
- fever
- joint pain
- skin rash
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Insight From A Dupixent Partial Responder
Rasmus Mikkel Soendergaard, a 34-year-old who lives in Copenhagen, Denmark, is a partial responder to Dupixent. He has been on the medication for about 14 months. Despite its failure to clear all aspects of his AD, he said has no intention of getting off it.
Rasmus Mikkel Soendergaard
Soendergaard struggles from several conditions that may or may not be related to his AD. For one, he has ankylosing spondylitis, a type of spinal arthritis that can worsen over time. He also has what he describes as unusual, small wounds that resemble ulcers and seem to develop underneath his skin and then erupt on the surface.
So far, his doctors havent been able to agree on the source of these ulcer-like symptoms, Soendergaard said. I have skin, joint, allergic and connective tissue symptoms, and its possible that some of these arent directly related to AD.
Dupixent may not be my be-all and end-all treatment, but because of it, my AD no longer affects my professional or personal life, he added. The treatment has cleared my skin from the neck down, and I have no asthma issues now.
Soendergaard uses a tacrolimus cream to manage the eczema patches on his face. For now, he describes himself as a successful partial responder whos waiting for something even better to come along.
Shi and her fellow researchers are certain that it will.
No more skin flakes on my desk and keyboard at work. No more depression. No more anxiety about being touched or touching others, Greenspun said.
How Long Does It Really Take Dupixent To Work
Drugs.com provides accurate and independent information on more than 24, or IL, MBA a plusBy texting HSI to 844-539-1128, Atopic Dermatitis: DUPIXENT is indicated for the treatment of patients aged 6 years and older with moderate-to-severe atopic dermatitis whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable,: Dupixent Changed My Itchy Red >Do not try to inject DUPIXENT until you have been shown the right way by your healthcare provider, and marketing communications from Institute of Health Sciences, The powerful drug is an antibody that patients inject just under Indications, reports, over-the-counter medicines and natural products, uses, In children 12 years of age and older, swelling of the face, and more
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Does Dupixent Treat Food Allergies
No, Dupixent is not used to treat food allergies at this time. While its currently being tested as a treatment for children with peanut allergies, its not approved for this use.
Dupixent is being tested along with another medication, called AR101, thats specifically used for peanut allergies. The idea is that using the combination of AR101 and Dupixent could allow childrens immune systems to learn not to react to peanuts. This would mean that children with severe peanut allergies who were exposed to peanuts wouldnt have a life-threatening allergic reaction.
Is Dupixent An Immunosuppressant Does It Lower The Activity Of Your Immune System
No, Dupixent is not an immunosuppressant. Instead, its a monoclonal antibody drug, which works on very specific targets within your immune system.
Dupixent isnt known to weaken your immune system in a way that makes it easier for you to get infections. Instead, the drug reduces inflammation signals in your immune system that can cause eczema, asthma, and chronic sinusitis.
Keep in mind that inflammation signals are important for your immune system to respond to certain vaccines. For information about receiving vaccines during Dupixent treatment, see Vaccine interactions in the What should be considered before taking Dupixent? section below.
If you have questions about Dupixents effects on your immune system, talk with your doctor.
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Working Together On A Solution
Shortly after starting treatment with Dupixent, Oryanna called me up and said, I can smell! Dr. Dass said. It was the biggest deal in the world for her. Her asthma symptoms are also more under control than they have been for a long time.
Oryannas nasal polyps reduced in size and she has not needed another surgery to remove her nasal polyps since starting Dupixent. Dupixent is the;first FDA-approved biologic shown to shrink nasal polyp size and improve the signs and symptoms of the associated CRSwNP.
The benefits and risks of Dupixent in moderate to severe asthma patients were evaluated in 3 clinical studies with 2,888 patients which showed up to 81% fewer asthma attacks. In separate studies of CRSwNP patients, Dupixent was clinically proven to significantly reduce nasal congestion and shrink nasal polyps when added to other nasal polyps medicines.
What Is In This Leaflet
This leaflet answers some common questions about Dupixent.
It does not contain all the available information. It does not take the place of talking to your Doctor or Pharmacist.
All medicines have risks and benefits. Your Doctor has weighed the risks of you using Dupixent against the benefits they expect it will have for you.
If you have any concerns about using this medicine, ask your Doctor or Pharmacist.
Keep this leaflet with the medicine. You may need to read it again.
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Will I Have Withdrawal Symptoms If I Stop Using Dupixent
Its not likely that youll experience withdrawal symptoms when you stop taking Dupixent.
However, if you take steroid pills such as prednisone to control your symptoms, you may have withdrawal symptoms if you stop taking those. Symptoms of withdrawal from suddenly stopping a steroid includes weakness, nausea, vomiting, and feeling tired.
You shouldnt stop taking steroid medications abruptly or without talking to your doctor. Its best to slowly lower your dose of steroids before stopping entirely.
Before You Start To Use Dupixent
Tell your doctor or pharmacist if you have allergies to any other medicines, or substances such as foods, preservatives or dyes.
Tell your Doctor if you have any of the following, or if any of the following apply to you:
- have a parasitic infection
- are pregnant or plan to become pregnant. It is not known if Dupixent will harm your unborn baby.
- are breastfeeding or plan to breastfeed. It is not known whether Dupixent passes into breast milk.
- have recently received or are scheduled to receive a vaccine
- any new or worsening eye problems, including eye pain or changes in vision.
- are taking oral, or using topical, or inhaled corticosteroid medicines
- have any other medical conditions
If you have not told your Doctor about any of the above, tell them before you start using Dupixent.
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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.
Researchers Investigate Dupixent Side Effects
Injection site reactions are among the most common side effects of the biologic Dupixent , followed by eye problems such as conjunctivitis and inflammation of the eye or eyelid, and cold sores on the lips or in the mouth.
According to a JAMA Dermatology study that published online May 1, 2019, Dupixent may cause a newly observed side effect in a subset of patients. Out of the 73 patients analyzed who were taking Dupixent, nearly one-fourth developed new regional dermatosis appearing mostly on the face.
The studys co-authors suspect these new symptoms may have something to do with allergic contact dermatitis, although this may not explain all cases.; The researchers indicate larger studies involving skin biopsies and patch testing are needed to better define the subset of patients to which this pertains.
A French study published online in the Journal of the American Academy of Dermatology on February 27, 2019, found that Dupixent may increase the risk for eosinophilia a higher-than-normal number of a type of disease-fighting white blood cells. This potential side effect has been previously reported in clinical trials; this study investigated it in a real-world setting.
About 57% of the 241 patients had elevated eosinophils within six months of their follow-up exam compared with 33.7% at the start of the study. The researchers indicated that further investigations are needed to determine if there is a clinical impact related to these findings.
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Dupilumab Significantly Reduced Steroid Use Asthma Attacks And Improved Lung Function In Phase 3 Study Of People With Severe Steroid
First study with a biologic to show benefit in severe steroid-dependent asthma population that enrolled patients regardless of blood eosinophil levels or any other Type 2 biomarkers at baselinePivotal program is first with a biologic to show consistent reductions in asthma attacks and improvements in lung function across a broad population of uncontrolled asthma patients
TARRYTOWN, N.Y.;and;PARIS,;Oct. 31, 2017;/PRNewswire/ –;Regeneron Pharmaceuticals, Inc.; and;Sanofi;today announced that the Phase 3 investigational study evaluating dupilumab in adults and adolescents with severe, steroid-dependent asthma met its primary endpoint and key secondary endpoints. For the primary endpoint, at 24 weeks in the overall population, dupilumab added to standard therapies significantly reduced the use of maintenance oral corticosteroids by 70 percent on average compared to 42 percent with placebo . In prespecified analyses of patients with baseline eosinophil counts greater than or equal to 300 cells/microliter, adding dupilumab significantly reduced OCS use by 80 percent on average compared to 43 percent for placebo .
In the Phase 3 study, known as LIBERTY ASTHMA VENTURE, additional secondary endpoint results at 24 weeks included the following:
For more information on dupilumab clinical trials please visit;www.clinicaltrials.gov.
IMPORTANT SAFETY INFORMATION;
- have eye problems