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IL-4Rα Inhibitor (Anti-IL-4/IL-13)

Dupilumab (CRSwNP)

Brand names: Dupixent

Dupilumab is a subcutaneously injected monoclonal antibody used as an add-on biologic for severe chronic rhinosinusitis with nasal polyps (CRSwNP) inadequately controlled by intranasal corticosteroids.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It is a human monoclonal antibody that blocks the shared alpha subunit of the interleukin-4 receptor, inhibiting IL-4 and IL-13 signalling and thereby dampening the type-2 inflammation that drives polyp formation.

Prescribing in practice

  • It should be initiated and supervised within specialist services against agreed eligibility criteria, as it is a high-cost biologic reserved for severe, refractory CRSwNP.
  • Conjunctivitis and other eye disorders are recognised adverse effects; new or worsening eye symptoms should be assessed.
  • Patients with coexisting helminth infection should have this treated before starting, and live vaccines should be avoided during therapy.

Monitoring

Monitor clinical response (symptom scores, polyp burden and need for surgery or rescue steroids) and review for ocular and hypersensitivity reactions.

Counselling the patient

  • This is a regular self-administered injection that works gradually rather than immediately.
  • Report new eye redness, irritation or visual changes to your team.
  • Continue your prescribed nasal corticosteroid alongside the injections unless told otherwise.

Evidence & guidelines

The SINUS-24 and SINUS-52 trials demonstrated reduced polyp size and improved symptoms in CRSwNP, supporting NICE-recommended use in eligible patients.

Reference: SINUS-24 & SINUS-52 trials (Bachert et al. NEJM 2019); NICE TA654; MHRA SPC Dupixent; EPOS 2020 European Position Paper on Rhinosinusitis; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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