The U.S. Food and Drug Administration (FDA) has approved Dupixent (dupilumab) for use as an add-on maintenance treatment in adolescent patients aged 12 to 17 years with inadequately controlled chronic rhinosinusitis with nasal polyps (CRSwNP). This decision, announced by Regeneron Pharmaceuticals and Sanofi, expands the drug's availability to a younger population, offering a new treatment option for a condition that can significantly impair breathing and sense of smell. The FDA granted priority review for this supplemental Biologics License Application because Dupixent has the potential to significantly improve the safety and effectiveness of treatment for a serious condition.
The approval is based on data from the Phase 3 SINUS-24 and SINUS-52 trials, which evaluated Dupixent in adults with CRSwNP. These trials demonstrated that Dupixent significantly improved nasal congestion, nasal polyp size, and sense of smell compared to placebo. The need for systemic corticosteroids or surgery was also reduced at 24 weeks in the Dupixent group. The efficacy data, coupled with pharmacokinetic and safety data from adolescent patients with moderate-to-severe asthma, supported the approval for the expanded indication.
Clinical Trial Data and Safety Profile
The SINUS-24 and SINUS-52 trials provided critical evidence of Dupixent's effectiveness. Patients treated with Dupixent experienced clinically meaningful improvements in several key endpoints, including a reduction in nasal congestion and polyp size. These improvements were accompanied by a notable enhancement in the sense of smell, a common complaint among individuals with CRSwNP. The safety profile of Dupixent in these trials was consistent with its established safety profile across other approved indications.
Adverse events observed more frequently with Dupixent compared to placebo included injection site reactions, eosinophilia, insomnia, toothache, joint pain, gastritis, and conjunctivitis. These adverse events were generally mild to moderate in severity and did not lead to treatment discontinuation in most cases.
Mechanism of Action and Broader Implications
Dupixent is a fully human monoclonal antibody that inhibits the signaling of the interleukin-4 (IL-4) and interleukin-13 (IL-13) pathways, key drivers of type 2 inflammation. By blocking these pathways, Dupixent helps to reduce inflammation and alleviate the symptoms of CRSwNP. This mechanism of action has proven effective in various other type 2 inflammatory diseases, including atopic dermatitis, asthma, eosinophilic esophagitis, prurigo nodularis, chronic spontaneous urticaria, and chronic obstructive pulmonary disease (COPD).
With this latest approval, Dupixent is now available to a broader range of patients, from infants to adults, suffering from type 2 inflammatory diseases. This milestone underscores the importance of targeted therapies in addressing the underlying causes of chronic conditions and improving patient outcomes.
