Biologics for Eczema: 5 Ways Dupixent and Adbry Compare

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Topical treatments applied to the skin have been the mainstay of atopic dermatitis (eczema) treatment. But if the redness and itching become hard to relieve, there are other options. If you have moderate-to-severe eczema, your dermatologist might suggest an injectable medication, such as a biologic. Biologics are medications that come from living sources.

Dupixent (dupilumab) and Adbry (tralokinumab-ldrm) are two biologics that treat moderate-to-severe eczema. Both treatments can be used alone or with topical treatments, such as corticosteroids. Despite these similarities, Dupixent and Adbry have some key differences. Here are five things to consider.

1. Dupixent and Adbry work slightly differently for eczema

Both Dupixent and Adbry are monoclonal antibodies - lab-made antibodies with specific targets in the body. They work to reduce inflammation by blocking certain proteins in your immune system. Dupixent blocks two proteins, while Adbry blocks one protein.

Both Dupixent and Adbry work by blocking the action of a protein called interleukin-13 (IL-13). IL-13 is found in higher amounts in eczema skin lesions. It plays a key role in creating symptoms such as inflammation and itching.

In addition to IL-13, Dupixent also blocks interleukin-4 (IL-4). IL-4 is also thought to play a role in eczema. And by blocking both IL-13 and IL-4, Dupixent targets multiple steps of the disease process.

2. Dupixent is approved for a wider age range compared to Adbry

Adbry and Dupixent are FDA-approved for different age groups. Both medications are approved for adults. But Adbry is approved for people ages 12 and older, while Dupixent is approved for people ages 6 months and older.

Dupixent was first studied in adolescents and children ages 6 to 11. It was later studied in children ages 6 months to 5 years. All of these studies showed that Dupixent was well-tolerated and helped reduce eczema symptoms.

Adbry's approval for adolescents is based on a 52-week clinical study that included people ages 12 to 17 with moderate-to-severe eczema. The study showed that Adbry was effective and well-tolerated in this age group. Adbry is currently being studied for eczema in children as young as 6 months, so it could be approved for younger children in the future.

3. Dupixent and Adbry have differences in their dosage schedules

Both Adbry and Dupixent are injected subcutaneously (under the skin). But there can be some differences in their dosage schedules and how many injections are required for your dose.

Adults receiving Dupixent or Adbry usually start with a loading dose (an initial higher dose). The Adbry loading dose uses 4 injections, while the Dupixent loading dose uses 2 injections. After that, Dupixent and Adbry are injected every other week. But adults who achieve clear or almost clear skin with Adbry after 16 weeks (about 4 months) may be able to inject it every 4 weeks instead.

Dupixent has specific weight-based dosing for children, while Adbry does not. And children under 5 years old receiving Dupixent aren't recommended to get a loading dose. All other children eligible for Dupixent or Adbry get a loading dose.

Another difference is that Dupixent is available in both prefilled syringes and injection pens. Some people may prefer the injection pen, especially children and people who don't like needles, since the needle is hidden during the administration process.

Similar to Dupixent, Adbry is available in prefilled syringes. It doesn't currently come in an injection pen, but that should change this year. The FDA has approved an Adbry injection pen, and it's expected to be available in the coming months. Compared with the syringe, the injection pen can also help cut down on the number of injections you'll need per dose.

After you've received training from a healthcare professional, you may be able to give yourself or your child Dupixent or Adbry injections at home. This may be more convenient than going to your dermatologist's office to get injections.

4. Dupixent and Adbry can cause slightly different side effects

Dupixent and Adbry can cause a few similar side effects, such as injection site reactions (e.g., pain, swelling, and bruising). One study found that people receiving Adbry reported more injection site reactions compared with those receiving Dupixent. But these were generally mild and didn't stop people from using either medication.

Dupixent and Adbry can also cause eye inflammation. However, Adbry might be less likely to cause eye side effects. Eye problems are common with moderate-to-severe eczema. And treatment with either medication may worsen eye symptoms for some people. But if you're experiencing eye-related side effects from Dupixent, your dermatologist may consider switching you to Adbry.

Besides injection site reactions and eye inflammation, Dupixent and Adbry can cause a few different side effects. For example, new or worsening joint pain has been reported with Dupixent. And upper respiratory tract infections have been reported with Adbry.

5. Dupixent has approved uses beyond eczema

Adbry is only FDA approved to treat eczema. But Dupixent has many other approved uses. Other health conditions Dupixent can be used for include:

• Moderate-to-severe asthma (eosinophilic type or needing oral steroids)

• Chronic rhinosinusitis with nasal polyps

• Eosinophilic esophagitis

• Prurigo nodularis (a skin condition with itchy bumps)

Your dermatologist might consider your other health conditions when prescribing one of these biologic medications for you. For example, some people with eczema may also have asthma. In those cases, Dupixent may be a good option to treat both at the same time.

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