Strachan is a board-certified dermatologist whose practice, Aglow Dermatology, is in New York City. The information here represents her knowledge and experience as a medical professional; Strachan was not involved in the development of or clinical trials for dupilumab (Dupixent).
Who Is This Treatment For?
Chronic spontaneous urticaria, aka CSU, happens when a person develops itchy hives that persist for over six weeks. Their condition may not consistently be controlled by antihistamines. Though triggers for CSU can include certain foods, meds, infections, or allergies, it still can be difficult to find a cause. People in this frustrating situation would benefit from a more effective option. Dupilumab (Dupixent) was originally developed to treat adults and children 12 years and up who fall into this group.
How Is This Treatment Different, and How Does It Work?
Dupilumab (Dupixent) is an injected, biologic drug that is taken every two weeks. Made from living organisms, biologics target specific parts of your immune system. Dupilumab (Dupixent) blocks a protein that can lead to inflammation and weaken your skin barrier. It is not immunosuppressive, meaning it doesn't weaken your immune system, or sedating, so it won't make you drowsy or sluggish.
If Dupixent proves to be effective for CSU, it will be a more convenient option for patients who haven't responded well to other treatments.
How Effective Is This Treatment?
The data I read reported results at 24 weeks, which showed about a 30% greater decrease in itch and hives compared to the placebo. (A placebo is a substance used in a trial that resembles the drug being tested but has no active properties. It's used to discern the medication's real effects from what people believe it will do.)
Dupilumab (Dupixent) achieves about a 50% reduction in itch and hive activity overall.
Is This Treatment Generally Considered Safe?
That is one of the great benefits of dupilumab (Dupixent) – it has a great safety profile. Some people get an injection site reaction – which goes away quickly – or eye irritation, which is rare in my experience.
What Are the Common Side Effects of This Treatment?
Side effects might include an injection site reaction, which may be pain, itching, or swelling where the needle went in. It usually goes away quickly and doesn't have to be treated. If someone is very uncomfortable after receiving Dupixent, they should talk with their doctor. Other effects that have been recorded are:
- Eye and eyelid inflammation. This may require you to stop taking the drug.
- Headaches
- Joint aches
- Nasopharyngitis. Another word for the common cold, it shows up as coughing, sneezing, or having a runny nose.
How Do You Take This Treatment? Will I Need Regular Tests or Checkups?
The drug can be injected into the subcutaneous fat – the fat just underneath your skin – usually in the inner thigh or lower abdomen. It comes in a syringe or in a self-injector pen. It can be given by the patient at home or in the office.
No tests are usually required to use dupilumab (Dupixent). Of course, you should follow up with your prescribing doctor to evaluate how the drug is working.
Are There Any People Who Shouldn't Take This Treatment?
Anyone who is allergic to any components of the drug should not take it. It's also contraindicated – meaning it's advisable to not take it – in people with severe asthma, helminthic parasite infections, eosinophilic pneumonia or vasculitis, and people taking live virus vaccines.
How Much Does This Treatment Cost? Will Insurance Cover It?
According to the company website, the list price of dupilumab (Dupixent) is $3,993.36 per carton, which is a one-month supply. Most people will not pay that out of pocket for the drug.
The good news is, insurance often does cover it. The company also has an assistance program that can help people get on the drug for two years if it is not covered by your insurance.
When Will This Treatment Be Available for CSU?
The FDA approved this treatment April 18, 2025. Your doctor should be able to help you find ways to get this medication if you need it.
How Can People Find Out More About Whether This Treatment Would Be a Good Fit for Them?
Visit a board-certified dermatologist to find out if this treatment is right for you. An allergist can be helpful, too, in cases of CSU. They can run tests that can help zero in on factors that might trigger your reactions.
What Other Insights Do You Have Into the Research and Studies Behind This Treatment?
This drug has had a great years-long safety profile for other indications, including:
- Calming inflammation that can happen with eczema and eosinophilic esophagitis (an immune system condition in which white blood cells called eosinophils build up in your esophagus)
- Stopping asthma symptoms that make your airways swell or narrow
It is now offering hope for people with chronic spontaneous urticaria, too.
