Weighing the Pros and Cons of Dupixent

After five months on Dupixent, also known as dupilumab, I get asked a lot of questions. The eczema community is now being offered different, serious drugs, so I get it. It can feel overwhelming. Taking that leap of faith isn't as easy as reading a leaflet.

But as someone who did take that leap of faith, hopefully my words can count for something.

How did I start Dupixent?

For years, I tried going the holistic route. From diets, to stem cell therapy, to Traditional Chinese Medicine... I did it all. There came a lot of ups and downs with that, including mentally. There is only so much one person can take. With flare after flare, I was being rocked. I wasn't able to focus on my life or moving forward. I didn't know what to do, so I decided enough was enough.

Has Dupixent worked for my eczema?

On Dupixent, I have been able to rest. The itch is gone and my skin is rarely a bother. I have small dry patches, but that's it. I'm not in pain or struggling to get out of bed in the morning. I feel lucky. Sometimes I even find myself rubbing my arms and face in awe.

What makes biologic drugs different?

With the more serious treatments, there is always trepidation for what they do to our bodies. Well, with Dupixent, it seems to be the most targeted of all the drugs. Immunosuppressives, like cyclosporine and methotrexate, are broad. They supress the entire immune system. This can leave people prone to infections and more serious issues if used long term. Same with JAK inhibitors. These drugs are less broad as immunosuppressives, but much less targeted that biologic drugs. Dupixent is a biologic.

Dupixent specifically hits our IL-4 and IL-13 pathway. These pathways deal with inflammation in the body. This makes the drug safer and less invasive in our system.

Are there concerns with long term use?

We never know what something can do long term in our body, but there have been patients on this drug since trials began in 2015/2016. They even did a 52-week long trial that came back with great results.¹ Most accounts at the moment are anecdotal, but it seems to be a safer option than most for long term use. Again, it doesn't suppress the entire immune system, so that eliminates a big scare.

Is Dupixent an easily accessible drug?

Man, it can be difficult getting your hands on this drug. And not only access, but then expenses. It is a very expensive, injectable drug. Tons of paperwork involved. Some get lucky and can apply for Dupixent My Way and have some of it paid for (or all), but it may change over time depending on your insurance.

It is also hard to travel with since it must stay refrigerated. So, you must make sure to have paperwork with you while flying, including a cooler.

Does it work for everyone?

Sadly, this is not a one-size-fits-all drug. It can work beautifully for some, and not for others. It can be slow acting for some, and not work at all for others. There are also four side effects that affect some individuals.

The most crippling is eye issues. Conjunctivitis has been seen a vast majority of patients. The percentage has risen, I believe. It used to be 1 in 10 patients, but I think it's more like 3 in 10 now.²

The other three side effects are red face (basically, a flare), joint problems, and cold sores. I get the cold sores. They are more annoying than anything else.

Is it effective long term?

This is the one that gives me anxiety. It may be safe long-term, but it doesn't mean it will stay effective long term. I dread waking up one day and finding that the drug is no longer working. This is not a cure. It is only masking whatever is happening under the surface. Remember that. So, if the drug stops working, patients could possibly go back to baseline - where they started.

My suggestion for this one is to always stay as healthy as possible. Don't just rely on the drug.

Overall, I really enjoy being on Dupixent. It's a personal choice, one we must all make for ourselves.