Dupixent for Treating Plaque Psoriasis - Effectiveness, Benefits, Considerations

Understanding Dupixent for Treating Psoriasis

Psoriasis is an autoimmune condition that leads to rapid buildup of skin cells, causing red, scaly, and often painful patches on the skin. It affects over 8 million Americans, and there is no cure. For moderate to severe cases, biologic medications like dupixent for psoriasis that target specific parts of the immune system can be highly effective.

What Is Dupixent?

Dupixent (dupilumab) is a biologic injection medication first approved by the FDA in 2017 to treat moderate-to-severe eczema (atopic dermatitis). It was later approved for other conditions like chronic rhinosinusitis with nasal polyps and asthma.

Dupixent is the first biologic medication that targets the interleukin-4 (IL-4) and interleukin-13 (IL-13) proteins to treat inflammatory conditions. These proteins play a major role in type 2 inflammation involved in several diseases.

How Dupixent Works for Psoriasis

Dupixent works differently than traditional systemic psoriasis treatments. It is an injectable biologic that blocks IL-4 and IL-13, two proteins that lead to overactive inflammation and symptoms of psoriasis.

First, a doctor or nurse administers an injection of Dupixent under the skin using a pre-filled syringe. Patients can also learn to self-administer shots at home. After injection, dupixent binds to IL-4 and IL-13 proteins, blocking them from activating more immune cells and promoting inflammation.

With less inflammation driven by these proteins, the overproduction of skin cells slows down leading to clearing of psoriatic plaques. Redness, scaling, itching, and tenderness improve.

Effectiveness of Dupixent for Treating Plaque Psoriasis

In clinical trials, dupixent for psoriasis has proven highly effective for treating plaque psoriasis, the most common form causing raised, red lesions with a silvery scale:

• Over 70% of patients achieve 75% clearer skin (PASI 75) after 16 weeks on Dupixent
• Over 50% of patients reach 90-100% clearer skin (PASI 90 - PASI 100) after 16 weeks
• Improvements in itch, redness, scaling, burning and tenderness have also been demonstrated
• Effects last across all areas of the body including the scalp

Benefits Over Other Psoriasis Systemics

Older systemic medications for psoriasis can work well but come with more safety concerns. For example, methotrexate and cyclosporine carry risks of liver and kidney toxicity. Acitretin produces side effects like hair loss and joint pain.

Dupixent offers similar improvement in symptoms but a lower occurrence of significant side effects compared to these other oral or injectable treatments:

• Conjuctivitis is the main side effect, occurring in around 10% of patients
• Low rates of serious infections, injection site reactions, and hypersensitivity reactions
• Does not produce hair loss, nausea, or liver test abnormalities

In addition, Dupixent for psoriasis can lead to lasting remissions for 6 months or more after stopping treatment based on clinical evidence. Other psoriasis systemics often lose effect shortly after discontinuing them.

Using With Topical or Phototherapy Psoriasis Treatments

For patients with very severe psoriasis, advanced cases not controlled well with other systemic medications, or psoriatic arthritis, dupixent also has proven benefits when combined with topical treatments or phototherapy:

• Calcipotriene topical cream can enhance dupixent's action when applied together
• UVB phototherapy 2-3 times per week also boosts dupixent efficacy
• Using dupixent with oral methotrexate did not increase benefit vs. dupixent alone

Considerations With Using Dupixent for Psoriasis

If you and your dermatologist are considering dupixent for psoriasis treatment, there are some important factors to review:

Administration and Cost Coverage

Dupixent requires injection under the skin every 2 weeks after a higher initial loading dose. Most insurance plans cover dupixent for plaque psoriasis, but out-of-pocket costs can still be $5,000+ annually without assistance.

You'll need prior authorization for insurance coverage. Copay assistance programs from the manufacturer can reduce costs significantly if approved by insurance. Talk to your doctor and insurance company about options to lower your dupixent expenses.

Time to Notice Improvements

In studies, patients report dupixent taking effect in under 4 weeks with maximal impact by 12-16 weeks. Around 20% of patients achieve total skin clearance after 6 months of treatment.

If dupixent works for you, maintenance injections every 2 weeks should maintain the improvement without losing response over time in most patients.

Safety Concerns and Side Effects

As with any medication, dupixent does come with potential side effects and safety considerations. These are relatively mild for most patients but important to discuss with your doctor:

• Conjunctivitis: Inflammation of the eyes occurs occasionally. Use artificial tears and wait for this to resolve.
• Hypersensitivity reactions: Seek medical care if you experience symptoms of serious allergic reaction.
• Parasitic infections: Rare but possible if traveling to areas with parasites.

Bottom line - talk with your dermatologist about whether trying dupixent for your psoriasis could be valuable for better managing stubborn, painful plaques after considering alternative treatments.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.