Overview
Dupilumab is a biologic that blocks IL-4 and IL-13 signalling by targeting the IL-4Rα receptor subunit. It is best known for atopic dermatitis and asthma, but is also approved for eosinophilic esophagitis (EoE) — a condition where eosinophil-driven inflammation causes difficulty swallowing and chest pain. It is given as subcutaneous injections.
Key Uses
Eosinophilic esophagitis (EoE) in adolescents and adults
Moderate-to-severe atopic dermatitis
Moderate-to-severe asthma (eosinophilic or type 2)
Chronic rhinosinusitis with nasal polyps
Prurigo nodularis
How It Works
Blocks shared receptor subunit (IL-4Rα) for IL-4 and IL-13 — key drivers of type 2 (Th2) inflammation
In EoE: reduces eosinophil infiltration in the oesophagus and promotes healing of oesophageal lining
For EoE: 300 mg SC every 2 weeks
Results in improved swallowing and reduced oesophageal eosinophil count
Safety & Self-Care
Generally well tolerated — does not broadly suppress immunity like anti-TNF agents
Most common side effects: injection site reactions, conjunctivitis (eye redness)
Unlike other IBD biologics, TB and hepatitis B screening are not routinely required
Continue food elimination or PPI therapy as directed alongside dupilumab for EoE
Avoid live vaccines during treatment
Follow up endoscopy is typically scheduled to assess histological response in EoE
Contact Your IMCC Team
Contact your IMCC team if swallowing difficulties persist or worsen, eye symptoms develop, you have severe injection site reactions, or before any planned surgery or pregnancy.
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