Chronic Spontaneous Urticaria (CSU)

Active Ingredient: Dupilumab

Indication for Dupilumab

Population group: only adolescents (12 years - 18 years old) , adults (18 years old or older)
Therapeutic intent: Curative procedure

Dupilumab is indicated for the treatment of moderate to severe chronic spontaneous urticaria in adult and adolescent (12 years and above) patients with inadequate response to H1 antihistamines and who are naive to anti-IgE therapy for CSU.

For this indication, competent medicine agencies globally authorize below treatments:

600 mg initial dose, followed by 300 mg given every other week

For:

Dosage regimens

Subcutaneous, 600 milligrams dupilumab, one dose, over the duration of 2 weeks. Afterwards, subcutaneous, 300 milligrams dupilumab, once every 2 weeks.

Detailed description

The recommended dose of dupilumab for adult patients is an initial dose of 600 mg, followed by 300 mg given every other week.

Missed dose

If an every other week dose is missed, administer the injection within 7 days from the missed dose and then resume the patient's original schedule. If the missed dose is not administered within 7 days, wait until the next dose on the original schedule.

Elderly (≥65 years)

No dose adjustment is recommended for elderly (≥65 years) patients.

Dosage considerations

Dupilumab is administered by subcutaneous injection into the thigh or abdomen, except for the 5 cm around the navel. If somebody else administers the injection, the upper arm can also be used.

It is recommended to rotate the injection site with each injection. Avoid injecting dupilumab into skin that is tender, damaged or has bruises or scars.

400 mg initial dose followed by 200 mg every other week or 600 mg initial dose followed by 300 mg every other week, based on body weight

For:

Dosage regimens

Regimen A, in case that patient weight is ≥ 30 kg and patient weight is < 60 kg

Subcutaneous, 400 milligrams dupilumab, one dose, over the duration of 2 weeks. Afterwards, subcutaneous, 200 milligrams dupilumab, once every 2 weeks.

Regimen B, in case that patient weight is ≥ 60 kg

Subcutaneous, 600 milligrams dupilumab, one dose, over the duration of 2 weeks. Afterwards, subcutaneous, 300 milligrams dupilumab, once every 2 weeks.

Detailed description

The recommended dose of dupilumab for adolescent patients 12 to 17 years of age is specified in the following table.

Dose of dupilumab for subcutaneous administration in adolescent patients 12 to 17 years of age with CSU:

Body WeightInitial DoseSubsequent Doses
30 to less than 60 kg400 mg200 mg every other week (Q2W)
60 kg or more600 mg300 mg every other week (Q2W)

Dupilumab dosing beyond 24 weeks has not been studied in CSU. After 24 weeks, the need for continued therapy should be periodically assessed. Consideration should be given to discontinuing treatment in patients who have shown no response after 24 weeks of treatment for CSU.

Missed dose

If an every other week dose is missed, administer the injection within 7 days from the missed dose and then resume the patient's original schedule. If the missed dose is not administered within 7 days, wait until the next dose on the original schedule.

Dosage considerations

Dupilumab is administered by subcutaneous injection into the thigh or abdomen, except for the 5 cm around the navel. If somebody else administers the injection, the upper arm can also be used.

It is recommended to rotate the injection site with each injection. Avoid injecting dupilumab into skin that is tender, damaged or has bruises or scars.

Active ingredient

Dupilumab

Dupilumab is a recombinant human IgG4 monoclonal antibody that inhibits interleukin-4 and interleukin-13 signaling. Dupilumab inhibits IL-4 signaling via the Type I receptor (IL-4Rα/γc), and both IL-4 and IL-13 signaling through the Type II receptor (IL-4Rα/IL-13Rα). IL-4 and IL-13 are major drivers of human type 2 inflammatory disease, such as atopic dermatitis, asthma, and CRSwNP. Blocking the IL-4/IL-13 pathway with dupilumab in patients decreases many of the mediators of type 2 inflammation.

Read more about Dupilumab

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