Drugs Q & A

Does Dupixent (dupilumab) Cause Weight Gain?

Various medications can contribute to weight fluctuations, often due to the side effects they produce. These drugs can impact your appetite, affecting whether you eat more or less. Additionally, they might influence how your body processes glucose, potentially leading to fat accumulation in the abdominal area. Some medications alter metabolism rates, causing calories to be burned at different rates. Others might induce fatigue or shortness of breath, making exercise challenging. Certain drugs can lead to water retention, adding weight without necessarily increasing fat content.

The extent of weight gain or loss varies from person to person and depends on the specific medication. Over the course of a year, some individuals might gain a few pounds, while others could experience significant weight gain or loss in just a few months. For those taking medications for chronic conditions, prolonged use could contribute to substantial changes in weight over time.

Recent research indicates an increasing number of individuals are prescribed drugs that can lead to weight gain. This is particularly notable for conditions that can be exacerbated by excess weight. Findings from the 2017-2018 National Health and Nutrition Examination Survey (NHANES) reveal that around 1 in 5 adults in the U.S. take at least one medication associated with weight gain.

While weight gain might not seem concerning when addressing life-threatening conditions, it’s worth noting that even in less severe cases, increased weight can impact overall health. Obesity is linked to elevated risks of serious diseases and health issues, such as heart disease, stroke, and premature death, according to the Centers for Disease Control and Prevention (CDC). Even a modest weight gain of five to twenty pounds can have negative effects on health, as suggested by research.

What is Dupixent and what is it used for?

Dupixent is the brand name for the medication whose generic name is dupilumab. It is a prescription biologic medication used to treat certain inflammatory conditions related to the immune system’s response. Dupixent is classified as a monoclonal antibody.

It is primarily used to treat two main conditions:

1.        Atopic Dermatitis (Eczema): Dupixent is approved for the treatment of moderate-to-severe atopic dermatitis in adults and adolescents (aged 12 and older) whose eczema is not well controlled with topical treatments or who should not use topical treatments. It helps reduce the symptoms associated with eczema, such as itching, redness, inflammation, and skin lesions.

2.        Asthma: Dupixent is also approved for specific cases of moderate-to-severe asthma in patients aged 12 and older. It is typically used for asthma that is not well managed with other asthma medications, such as inhaled corticosteroids combined with long-acting beta-agonists.

How does Dupixent work?

Dupixent (dupilumab) works by targeting specific molecules in the immune system that play a key role in inflammatory responses. It is classified as a monoclonal antibody, which is a type of biologic medication designed to target specific proteins in the body.

Dupixent primarily targets two proteins called interleukin-4 (IL-4) and interleukin-13 (IL-13). These proteins are part of the immune system’s signaling pathways and are involved in allergic and inflammatory reactions. By inhibiting the effects of IL-4 and IL-13, Dupixent helps to regulate and dampen the inflammatory processes associated with certain conditions.

In the context of specific conditions, here’s how Dupixent works:

1.        Atopic Dermatitis (Eczema): In individuals with eczema, the immune system’s response is overly active, leading to inflammation, itching, redness, and other symptoms. Dupixent works by blocking the effects of IL-4 and IL-13, which are responsible for promoting inflammation and allergic reactions in the skin. By inhibiting these proteins, Dupixent helps to reduce the symptoms of eczema, providing relief from itching, improving skin appearance, and enhancing overall quality of life.

2.        Asthma: For individuals with certain forms of moderate-to-severe asthma that is not well-controlled with standard asthma medications, Dupixent can help reduce inflammation in the airways. By targeting IL-4 and IL-13, it can help decrease the inflammation and hyperreactivity that contribute to asthma symptoms. This can lead to improved lung function, reduced asthma exacerbations, and better overall asthma control.

Overall, Dupixent’s mechanism of action involves modulating the immune response, particularly by reducing the production and

How should Dupixent be used?

To properly use Dupixent, it’s essential to follow your doctor’s instructions precisely. Below are the guidelines for using Dupixent, but please consult your healthcare provider for personalized guidance:

1.        Administration Frequency: Dupixent is usually injected under the skin every 2 to 4 weeks. Your initial dose might involve 2 injections.

2.        Injection Technique: Your healthcare provider might teach you how to administer the medication yourself. It’s crucial to read and understand the provided Instructions for Use. Don’t hesitate to ask your doctor or pharmacist for clarification if needed.

3.        Preparation: Do not shake the prefilled syringe or injection pen. Only prepare the injection when you’re ready to use it. If the medication appears cloudy, has changed color, or contains particles, do not use it. Contact your pharmacist for replacement.

Each prefilled syringe or injection pen is meant for a single use only. Dispose of it after one use, even if some medicine remains.

The pre-filled pen is intended for use in adults and children aged 12 and older, while the pre-filled syringe is suitable for adults and children aged 6 months and older.

Below are the dosing recommendations for Dupixent for various conditions:

•          Atopic Dermatitis: Initial dose of 600 mg, followed by a maintenance dose of 300 mg every other week.

•          Asthma: Initial dose of 400 mg or 600 mg, followed by a maintenance dose of 200 mg or 300 mg every other week, depending on your situation.

•          Sinusitis: Maintenance dose of 300 mg every other week.

•          Eosinophilic Esophagitis: Maintenance dose of 300 mg weekly.

•          Prurigo Nodularis: Initial dose of 600 mg, followed by a maintenance dose of 300 mg every other week.

•          Pediatric Atopic Dermatitis: Dosage varies based on age and weight, ranging from 200 mg every 4 weeks to 300 mg every 4 weeks.

It’s important to remember that this information is a general overview. Your doctor will determine the appropriate dose and frequency for your specific condition and individual factors. Always follow your healthcare provider’s recommendations for safe and effective use.

Does Dupixent cause weight gain?

Yes, studies have shown that Dupixent can cause weight gain. However, it is not a commonly reported side effect. As with any medication, individual responses can vary, and there might be cases where some people experience changes in weight while using Dupixent while others do not.

If you believe that Dupixent is causing weight gain for you, it’s important to address your concerns with your healthcare provider. They can provide you with personalized guidance based on your medical history, current health status, and the specific side effects you’re experiencing. Here are some steps to consider:

1.        Consult Your Healthcare Provider: Reach out to the healthcare professional who prescribed Dupixent for you. Explain your concerns about weight gain and any other side effects you may be experiencing. They can help determine if the weight gain is indeed related to the medication and discuss potential strategies.

2.        Discuss Alternative Options: Your healthcare provider may evaluate whether Dupixent is the best treatment option for you or if there are alternative medications that could be considered without the potential side effect of weight gain.

3.        Assess Lifestyle Factors: It’s important to consider other factors that might contribute to weight gain, such as changes in diet, physical activity, or underlying health conditions. Your healthcare provider can help assess these factors and provide recommendations for maintaining a healthy lifestyle.

4.        Monitor Weight and Progress: Keep track of your weight and any changes you notice over time. Regular monitoring can help you and your healthcare provider understand the extent of the weight gain and whether any adjustments are needed.

5.        Discuss Strategies: If your healthcare provider confirms that the weight gain is likely related to Dupixent, they can discuss strategies to manage it. This might include dietary changes, exercise recommendations, and other lifestyle modifications.

6.        Balance Benefits and Risks: Consider the overall benefits of Dupixent in managing your condition against the potential side effects. If the medication is effectively controlling your symptoms, your healthcare provider might help you find ways to manage the weight gain while continuing the treatment.

7.        Collaborate on a Plan: Work together with your healthcare provider to develop a comprehensive plan that addresses your health needs, including the management of any side effects like weight gain.

8.        Seek Support: If you’re struggling with weight gain, consider seeking support from a registered dietitian, nutritionist, or mental health professional. They can provide guidance on healthy eating habits and coping strategies.

Remember that every individual’s response to medication can vary, and your healthcare provider is the best resource for personalized advice. Don’t make any changes to your treatment plan without consulting them first. Open communication and collaboration with your healthcare team are key to finding the best solution for your health and well-being.

Dupixent Side Effects

Dupixent has the potential to induce severe side effects. Notify your doctor immediately if you experience:

•          Increasing or fresh eye pain or discomfort.

•          Changes in your vision.

•          Enhanced sensitivity of your eyes to light, causing watery eyes.

•          Rapid heartbeat.

•          Abdominal cramps.

•          Sensation of foreign matter in your eye.

•          Blood vessel inflammation: Indications include fever, chest pain, difficulty breathing, skin rash, or a tingling sensation in your arms or legs.

Frequent side effects of Dupixent may consist of:

•          Pain, swelling, burning, or irritation at the injection site.

•          Blood vessel inflammation.

•          Redness or itching of the eyes, coupled with puffy eyelids.

•          Stomach distress, along with symptoms like nausea, vomiting, or diarrhea.

•          Sore throat.

•          Tooth pain.

•          Insomnia, leading to difficulty sleeping.

•          Typical cold symptoms, including nasal congestion, sneezing, and a sore throat.

•          Skin issues like sores, blisters, itching, tingling, or a burning sensation in the lower back or thigh area.

•          Joint or muscle discomfort.

•          Cold sores or fever blisters emerging on the lips or inside the mouth.

This list does not encompass all possible side effects, and additional reactions could arise. For comprehensive medical counsel on side effects, contact your doctor. You can also report side effects to the FDA at 1-800-FDA-1088. Always confer with your healthcare provider to receive accurate information tailored to your specific condition.

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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