Dupilumab
Anti–IL-4Rα monoclonal antibody (blocks IL-4 and IL-13)
- Response rate
- ~75% polyp reduction
- Onset
- 4–8 weeks
- Route
- SC 300mg every 2 weeks
- Line
- 1st-line biologic
- IgM effect
- Reduces polyp score by ~2 points (NPS)
Evidence summary
Blocks both IL-4 and IL-13 signalling via IL-4Rα. SINUS-24 and SINUS-52 trials demonstrated significant improvements in nasal polyp score (NPS), nasal congestion, Lund-Mackay CT score, SNOT-22, and olfaction (UPSIT). FDA-approved 2019. The most broadly effective biologic with consistent benefit across multiple outcomes.
Molecular targets (2)
| Molecule | Role | Expression | Evidence |
|---|---|---|---|
| IL-4 | Type 2 master cytokine | Elevated | established |
| IL-13 | Effector cytokine / tissue remodeller | Elevated | established |