Dupixent (dupilumab) is a prescription medication used to treat several inflammatory conditions, including moderate-to-severe eczema (atopic dermatitis), certain types of asthma, chronic rhinosinusitis with nasal polyps, eosinophilic esophagitis, prurigo nodularis, chronic spontaneous urticaria, and bullous pemphigoid. Like other medications, Dupixent can cause side effects. Joint aches and pain are a reported concern for some individuals using this treatment.
Understanding Dupixent and Joint Pain
Joint pain (arthralgia) is a recognized side effect of Dupixent, though it is not among the most common adverse reactions. While injection site reactions, eye problems, and upper respiratory tract infections are frequently reported, joint pain appears less often. Clinical trials have indicated that joint pain occurred in a small percentage of patients, such as 3% of those treated for chronic rhinosinusitis with nasal polyps, 2% for eosinophilic esophagitis, and 3.1% for chronic obstructive pulmonary disease. Some individuals have also reported muscle pain.
The onset of Dupixent-related joint pain can vary, appearing anywhere from days to several months after beginning treatment. The precise reason Dupixent may cause joint pain is not fully understood. Dupixent works by blocking the signals of two proteins, interleukin-4 (IL-4) and interleukin-13 (IL-13), which are involved in inflammation within the body. One theory suggests that by inhibiting IL-4 and IL-13, Dupixent might inadvertently increase inflammation mediated by another protein, IL-17, in some individuals, contributing to joint pain. It is important to differentiate this pain from joint pain caused by other underlying conditions.
The Resolution of Joint Pain
For many, joint pain experienced on Dupixent can be temporary, with symptoms resolving even while continuing treatment. However, individual experiences can vary, and for others, the pain might persist. The severity of the pain can influence its course; milder symptoms may allow for continued Dupixent use, while more severe pain might necessitate a re-evaluation of treatment.
Joint pain can start relatively early after beginning Dupixent therapy, with many cases appearing within four months, and some even immediately after the first injection. If the pain is severe or widespread, it may lead to discontinuation of the medication. In some instances, symptoms have resolved after stopping Dupixent.
However, discontinuing Dupixent is not always necessary, especially for mild forms of joint pain. Factors such as age, sex, or pre-existing joint issues do not seem to increase the risk of developing joint pain from Dupixent. It is possible for some side effects, though rare, to persist after stopping treatment.
Coping with Joint Pain While on Treatment
Individuals experiencing new or worsening joint pain on Dupixent should communicate these symptoms to their healthcare provider for assessment. Healthcare providers might recommend various management strategies to alleviate the discomfort.
Over-the-counter pain relievers, such as acetaminophen or topical anti-inflammatory medications like diclofenac, may be suggested. For those with asthma, oral anti-inflammatories like ibuprofen should generally be avoided. Physical therapy, gentle exercises such as swimming, and relaxation techniques might also offer relief.
In cases where joint pain is severe or does not improve, a doctor might consider prescribing other medications, or in some instances, recommend stopping Dupixent. Any decision regarding dose adjustment or discontinuation must be made in consultation with a healthcare professional, as stopping the medication could lead to a return or worsening of the treated condition’s symptoms.