"The groundwork of all happiness is health." - Leigh Hunt

Harvard Health Ed Watch: A brand new injectable treatment for eczema

Dry, itchy, red skin is a trademark of eczema. If you've eczema and have seen This ad, you might be pondering of dupixent (dupilumab). Does this recent drug work as advertised? Where does promoting hit the mark, and where can it improve?

Medicines only treat one kind of eczema.

While “eczema” and “atopic dermatitis” are used interchangeably within the ad, the conditions aren't the exact same. Eczema is an umbrella term that features:

  • Atopic dermatitis, which occurs in individuals with asthma and environmental allergies, similar to hay fever
  • Contact dermatitis, which is an allergic response to a substance that touches the skin, similar to soap, perfumed products, or poison ivy
  • Inflammation of the skin accompanied by swelling of the legs.

Atopic dermatitis is the one skin condition for which Dupixent is approved.

Pitch

Every ad is a sales pitch, whether it uses real people or paid actors. Here we see real people drumming in a band, playing the piano or trombone, and baking within the kitchen. A voiceover says “With less eczema, you can show more skin. So, roll up those sleeves and help heal your skin from the inside out with Dupixent.” Pitch? People with eczema may be embarrassed by it and take a look at to cover it – and effective treatments mean you don't should cover your skin.

We hear next that it's “the first treatment of its kind to treat moderate to severe eczema, or atopic dermatitis, even between flare-ups.” The viewer sees an outstretched arm with red spots that clear up in a second or two. Of course, that doesn't occur in real life. It may take weeks to see improvement.

More disturbingly, the voiceover tells us that the drug “… is a biologic, not a cream or a steroid.” You could also be wondering what's a “biological” drug? Please mark this query below for further clarification. “Many people who took Dupixent saw clear or almost clear skin and had significantly less itching. That's the difference you can feel..

Side effects, warnings, and a tagline

Warnings can raise eyebrows. “Do not use Dupixent if you are allergic to it. Severe allergic reactions may occur, including anaphylaxis, which is severe. Tell your doctor about new or worsening eye problems, such as eye pain or changes in vision. or parasitic infection. If you use asthma medications, do not stop or change them without talking to your doctor..

Quickly, though, the ad moves to a glowing tagline: “So help heal your skin from the inside out” and recommends talking to “your eczema specialist” about Dupixent. It may be tricky: Most individuals with eczema see their primary care physician, not a dermatologist.

The ad becomes valid.

It's true that folks with eczema may attempt to hide it and that effective treatment may be liberating, making them less concerned about others seeing their skin. Dupixent is, in truth, neither a cream nor a steroid, which is an old, common treatment for eczema. And, yes, Dupixent is a first-of-its-kind treatment for eczema. It blocks a chemical called interleukin 4 (IL-4), which plays a crucial role on this skin disease.

What else should you think about if you've atopic dermatitis?

  • How is it normally treated? Mild cases of atopic dermatitis may reply to skin moisturizers or medicated creams, gels, or ointments, a few of which contain steroids. But it might not be effective for more severe eczema.
  • What is biology? These drugs are made in living systems similar to microorganisms, human or animal cells, or plant cells. They are sometimes antibodies that block a substance within the body that is believed to cause or contribute to disease. Because biologics are often large molecules which are destroyed during digestion when taken in pill form, they are often only available by injection. Dupixent is injected every two weeks.
  • Why are eye problems, parasites and asthma mentioned within the warnings? Eye inflammation was a side effect of the drug within the study that led to the approval. IL-4 is regarded as a crucial a part of our immune defenses against parasitic infections, and few of the study participants developed parasitic infections. As for asthma, Dupixent is an approved treatment for asthma when combined with other medications. So, when you've had asthma and it's gotten higher while treating your atopic dermatitis, you might be tempted to taper off your other medications — nevertheless it's not protected to achieve this without medical supervision.
  • What about the price? Biologicals are expensive. The annual cost of this drug is about $40,000 a yr. Even when covered by medical insurance, copays and deductibles could make this an expensive treatment.
  • Does it work? The text that appears on the screen states that 37% of adults and 24% of adolescents had a significant improvement after 4 months of treatment, compared with lower than 10% of those not taking dupoxetine. It's great when you're within the minority of people that have made dramatic improvements. Or it might seem to be modest success for a systemic treatment with a major risk of negative effects and a big price tag.

The bottom line

Drug ads exist to sell a product. They should never be your primary source of health and treatment information. For this, seek the advice of your health care providers and other reliable sources of knowledge similar to FDA or NIH. Their primary interest is to supply accurate information and promote public health and drug safety, not to steer you to make use of a selected drug.