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DUPIXENT is indicated as an add-on maintenance treatment of adult and pediatric patients aged 6 years and older with moderate-to-severe asthma characterized by an eosinophilic phenotype or with oral corticosteroid dependent asthma.
Limitations of Use: DUPIXENT is not indicated for the relief of acute bronchospasm or status asthmaticus.

Open Up their World

TO BETTER ASTHMA CONTROL BY PARTNERING
WITH AN ASTHMA SPECIALIST

Not actual
DUPIXENT patients.

Consider partnering with an asthma specialist to help your appropriate patients with uncontrolled moderate-to-severe asthma

find an asthma specialist

IDENTIFYING UNCONTROLLED ASTHMA PATIENTS

Not an actual
DUPIXENT patient.

If your patients have had 2 or more OCS bursts or if they’ve
experienced persistent symptoms in the past year, they may
have uncontrolled asthma1

Uncontrolled asthma symptoms using the rule of ≥2

Your patient may be uncontrolled if they experience 2 or more of the following1,2:

  • ≥2 rescue inhaler uses per week
  • ≥2 nighttime awakenings per month
  • ≥2 refills of a quick-relief inhaler per year for symptom relief (excluding need for exercise-induced bronchospasms)

Identifying the signs and symptoms of uncontrolled asthma1

  • Cough
  • Shortness of breath
  • Wheezing
  • Nighttime awakenings due to asthma
  • Frequent exacerbations
  • Impaired lung function (airflow limitations)
  • Frequent albuterol use
  • Activity limitation due to asthma

Repeated OCS use

Did you know?
78%

of adult asthma patients who were
seeing an asthma specialist received an
OCS prescription from someone other
than their specialist.3

Ask your patient if they’ve received OCS from
another HCP.

  • 2 or more OCS bursts in the past year may be a sign of
    uncontrolled asthma1
  • Potential short-term side effects of OCS use include:
    increased risk of fracture, sleep disturbance, increased risk of
    infection, increased risk of thromboembolism1
  • Potential long-term side effects of OCS use include: obesity,
    cataracts, diabetes, anxiety/depression, hypertension,
    osteoporosis, adrenal suppression1

The Global Initiative for Asthma (GINA) recommends using OCS as a short-term option for treating asthma exacerbations and considers them a last resort for continuous treatment. Maintenance OCS should only be considered for those patients who have poor asthma control despite adherence with Step 5 treatment and a trial of add-on treatments including biologics where appropriate1,a

Consider partnering with an allergist or pulmonologist to start a biologic trial with DUPIXENT, the only biologic indicated specifically for OCS-dependent patients.1

aStep 5 treatment includes high-dose ICS-LABA plus OCS or biologic therapy plus high-dose ICS-LABA.1

Do you see these common asthma patient types in your office?

Patient profiles are representative and are not actual DUPIXENT patients.

Uncontrolled asthma patient
with elevated EOS, a marker
of type 2 inflammation1

Patient complaints

  • Limits outdoor activities due to fear of exacerbations
  • Exhausted by frequent urgent care visits due to asthma attacks
  • Misses out on some of her child’s activities due to shortness of breath

Diagnostic/Clinical findings

  • Elevated blood EOS ≥150 cells/μL
  • Reduced lung function (percent predicted FEV1: 64%)
  • On ICS/LABA
  • Frequent use of albuterol
  • May also have:
    • Elevated FeNO
    • Elevated IgE
    • Childhood history of asthma
VIEW THE EXACERBATION
REDUCTION DATA VIEW THE LUNG FUNCTION
IMPROVEMENT DATA
Uncontrolled asthma patient
with type 2 inflammation
requiring multiple OCS bursts

Patient complaints

  • Shortness of breath restricts him from being physically active despite albuterol use
  • Frustrated with recent weight gain and sleep disturbance due to frequent OCS use
  • Tired of missing family events due to asthma attacks

Diagnostic/Clinical findings

  • Multiple OCS bursts this year
  • Recent history of elevated EOS
VIEW THE OCS REDUCTION DATA
Child with uncontrolled asthma
and elevated EOS, a marker of
type 2 inflammation1

Patient complaints

  • Difficulty keeping up with her friends at recess because she cannot catch her breath
  • Her parents are afraid she might experience an asthma attack while on a field trip
  • Her parents want to limit SCS use when possible because of potential side effects

Diagnostic/Clinical findings

  • Elevated EOS: ≥150 cells/μL
  • Reduced lung function (percent predicted FEV1: 74%)
  • On ICS/LABA
  • May also have:
    • Elevated FeNO
    • Elevated IgE
    • History of allergic rhinitis
VIEW THE PEDIATRIC DATA

The Burden of Uncontrolled Asthma

Uncontrolled asthma can lead to significant patient burden1

Persistent
airflow
limitation
Activity
reduction
Urgent care
exacerbations
Increased OCS
exposure

The long-term goals of asthma management include achieving good control of asthma and maintaining normal activity levels.1

Uncontrolled asthma may be a sign of type 2 inflammation1

UP TO
84%

of adult asthma patients present
with type 2 inflammation4,5

The role of biologics in uncontrolled asthma treatment

If your patient’s asthma remains uncontrolled after ~3 to 6 months, they may have severe asthma and should be assessed by a specialist.1

  • For patients with underlying type 2 inflammation, GINA recommends that specialists consider add-on biologic therapy, which differs from ICS or LABA in that their use depends on the patient’s inflammatory phenotype and other clinical features1

LEARN MORE ABOUT
DUPIXENT EFFICACY

DUPIXENT is not a steroid or an immunosuppressant6

DUPIXENT is a dual inhibitor of IL-4 and IL-13 signaling.6,b

bThe mechanism of dupilumab action has not been definitively established.6

EOS, eosinophils; FeNO, fractional exhaled nitric oxide; FEV1, forced expiratory volume in 1 second; ICS, inhaled corticosteroid; LABA, long-acting beta agonist; OCS, oral corticosteroid; SCS, systemic corticosteroid.

IMPORTANT SAFETY
INFORMATION AND INDICATIONS

CONTRAINDICATION: DUPIXENT is contraindicated in patients with known hypersensitivity to dupilumab or any of its excipients.

WARNINGS AND PRECAUTIONS

Hypersensitivity: Hypersensitivity reactions, including anaphylaxis, serum sickness or serum sickness-like reactions, angioedema, generalized urticaria, rash, erythema nodosum, and erythema multiforme have been reported. If a clinically significant hypersensitivity reaction occurs, institute appropriate therapy and discontinue DUPIXENT.

Conjunctivitis and Keratitis: Conjunctivitis and keratitis occurred more frequently in AD subjects who received DUPIXENT versus placebo, with conjunctivitis being the most frequently reported eye disorder. Conjunctivitis also occurred more frequently in adult CRSwNP subjects, PN subjects, and COPD subjects who received DUPIXENT compared to those who received placebo. Conjunctivitis and keratitis have been reported with DUPIXENT in postmarketing settings, predominantly in AD patients. Some patients reported visual disturbances (e.g., blurred vision) associated with conjunctivitis or keratitis. Advise patients or their caregivers to report new onset or worsening eye symptoms to their healthcare provider. Consider ophthalmological examination for patients who develop conjunctivitis that does not resolve following standard treatment or signs and symptoms suggestive of keratitis, as appropriate.

Eosinophilic Conditions: Patients being treated for asthma may present with serious systemic eosinophilia sometimes presenting with clinical features of eosinophilic pneumonia or vasculitis consistent with eosinophilic granulomatosis with polyangiitis (EGPA), conditions which are often treated with systemic corticosteroid therapy. These events may be associated with the reduction of oral corticosteroid therapy. Healthcare providers should be alert to vasculitic rash, worsening pulmonary symptoms, cardiac complications, and/or neuropathy presenting in their patients with eosinophilia. Cases of eosinophilic pneumonia were reported in adult subjects who participated in the asthma development program and cases of vasculitis consistent with EGPA have been reported with DUPIXENT in adult subjects who participated in the asthma development program as well as in adult subjects with co-morbid asthma in the CRSwNP development program. A causal association between DUPIXENT and these conditions has not been established.

Acute Symptoms of Asthma or Chronic Obstructive Pulmonary Disease or Acute Deteriorating Disease: Do not use DUPIXENT to treat acute symptoms or acute exacerbations of asthma or COPD, acute bronchospasm, or status asthmaticus. Patients should seek medical advice if their asthma or COPD remains uncontrolled or worsens after initiation of DUPIXENT.

Risk Associated with Abrupt Reduction of Corticosteroid Dosage: Do not discontinue systemic, topical, or inhaled corticosteroids abruptly upon initiation of DUPIXENT. Reductions in corticosteroid dose, if appropriate, should be gradual and performed under the direct supervision of a healthcare provider. Reduction in corticosteroid dose may be associated with systemic withdrawal symptoms and/or unmask conditions previously suppressed by systemic corticosteroid therapy.

Patients with Co-morbid Asthma: Advise patients with co-morbid asthma not to adjust or stop their asthma treatments without consultation with their physicians.

Arthralgia: Arthralgia has been reported with the use of DUPIXENT with some patients reporting gait disturbances or decreased mobility associated with joint symptoms; some cases resulted in hospitalization. Advise patients to report new onset or worsening joint symptoms. If symptoms persist or worsen, consider rheumatological evaluation and/or discontinuation of DUPIXENT.

Parasitic (Helminth) Infections: It is unknown if DUPIXENT will influence the immune response against helminth infections. Treat patients with pre-existing helminth infections before initiating therapy with DUPIXENT. If patients become infected while receiving treatment with DUPIXENT and do not respond to anti-helminth treatment, discontinue treatment with DUPIXENT until the infection resolves. Helminth infections (5 cases of enterobiasis and 1 case of ascariasis) were reported in pediatric patients 6 to 11 years old in the pediatric asthma development program.

Vaccinations: Consider completing all age-appropriate vaccinations as recommended by current immunization guidelines prior to initiating DUPIXENT. Avoid use of live vaccines during treatment with DUPIXENT.

ADVERSE REACTIONS:

Most common adverse reactions are:

  • Atopic Dermatitis (incidence ≥1%): injection site reactions, conjunctivitis, blepharitis, oral herpes, keratitis, eye pruritus, other herpes simplex virus infection, dry eye, and eosinophilia. The safety profile in pediatric patients through Week 16 was similar to that of adults with AD. In an open-label extension study, the long-term safety profile of DUPIXENT ± TCS in pediatric patients observed through Week 52 was consistent with that seen in adults with AD, with hand-foot-and-mouth disease and skin papilloma (incidence ≥2%) reported in patients 6 months to 5 years of age. These cases did not lead to study drug discontinuation.
  • Asthma (incidence ≥1%): injection site reactions, oropharyngeal pain, and eosinophilia.
  • Chronic Rhinosinusitis with Nasal Polyps (incidence ≥1% in adult patients): injection site reactions, eosinophilia, insomnia, toothache, gastritis, arthralgia, and conjunctivitis.
  • Eosinophilic Esophagitis (incidence ≥2%): injection site reactions, upper respiratory tract infections, arthralgia, and herpes viral infections.
  • Prurigo Nodularis (incidence ≥2%): nasopharyngitis, conjunctivitis, herpes infection, dizziness, myalgia, and diarrhea.
  • Chronic Obstructive Pulmonary Disease (incidence ≥2%): viral infection, headache, nasopharyngitis, back pain, diarrhea, arthralgia, urinary tract infection, local administration reactions, rhinitis, eosinophilia, toothache, and gastritis.
USE IN SPECIFIC POPULATIONS
  • Pregnancy: A pregnancy exposure registry monitors pregnancy outcomes in women exposed to DUPIXENT during pregnancy. To enroll or obtain information call 1-877-311-8972 or go to https://mothertobaby.org/ongoing-study/dupixent/. Available data from case reports and case series with DUPIXENT use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes. Human IgG antibodies are known to cross the placental barrier; therefore, DUPIXENT may be transmitted from the mother to the developing fetus.
  • Lactation: There are no data on the presence of DUPIXENT in human milk, the effects on the breastfed infant, or the effects on milk production. Maternal IgG is known to be present in human milk. The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for DUPIXENT and any potential adverse effects on the breastfed child from DUPIXENT or from the underlying maternal condition.

Please see accompanying full Prescribing Information

INDICATIONS

Asthma: DUPIXENT is indicated as an add-on maintenance treatment of adult and pediatric patients aged 6 years and older with moderate-to-severe asthma characterized by an eosinophilic phenotype or with oral corticosteroid dependent asthma. Limitations of Use: DUPIXENT is not indicated for the relief of acute bronchospasm or status asthmaticus.

Atopic Dermatitis: DUPIXENT is indicated for the treatment of adult and pediatric patients aged 6 months and older with moderate-to-severe atopic dermatitis (AD) whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable. DUPIXENT can be used with or without topical corticosteroids.

Chronic Rhinosinusitis with Nasal Polyps: DUPIXENT is indicated as an add-on maintenance treatment in adult and pediatric patients aged 12 years and older with inadequately controlled chronic rhinosinusitis with nasal polyps (CRSwNP).

Eosinophilic Esophagitis: DUPIXENT is indicated for the treatment of adult and pediatric patients aged 1 year and older, weighing at least 15 kg, with eosinophilic esophagitis (EoE).

Prurigo Nodularis: DUPIXENT is indicated for the treatment of adult patients with prurigo nodularis (PN).

Chronic Obstructive Pulmonary Disease: DUPIXENT is indicated as an add-on maintenance treatment of adult patients with inadequately controlled chronic obstructive pulmonary disease (COPD) and an eosinophilic phenotype. Limitations of Use: DUPIXENT is not indicated for the relief of acute bronchospasm.

References:

  1. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. Updated 2024. Accessed June 10, 2024. https://ginasthma.org/wp-content/uploads/2024/05/GINA-2024-Strategy-Report-24_05_22_WMS.pdf
  2. Millard M, Hart M, Barnes S. Validation of Rules of Two™ as a paradigm for assessing asthma control. Proc (Bayl Univ Med Cent). 2014;27(2):79-82.
    doi:10.1080/08998280.2014.11929063
  3. Polling conducted by the Asthma and Allergy Foundation of America, May-June 2018.
  4. Peters MC, Kerr S, Dunican EM, et al; National Heart, Lung and Blood Institute Severe Asthma Research Program 3. Refractory airway type 2 inflammation in a large subgroup of asthmatic patients treated with inhaled corticosteroids. J Allergy Clin Immunol. 2019;143(1):104-113.e14. doi:10.1016/jjaci.2017.12.1009
  5. Jackson DJ, Aljamil N, Roxas C, et al. The ‘T2-low’ asthma phenotype: could it just be T2-high asthma treated with corticosteroids? Thorax. 2018;73(suppl 4):A124-A125. Abstract P48.
  6. DUPIXENT Prescribing Information.