Harvard Health Ad Watch: A new injection treatment for eczema


An ad for a new eczema drug leaves some questions unanswered.

Dry, itchy, reddened skin is the hallmark of eczema. If you have eczema and have seen this ad, you may be wondering about Dupixent (dupilumab). Does this new drug work as well as it looks in the ad? Where does the ad hit the brand and where could it do better?

The drug only treats one type of eczema

Although the ad uses “eczema” and “atopic dermatitis” interchangeably, these conditions are not exactly the same. Eczema is an umbrella term that includes:

  • atopic dermatitis, which develops in people prone to asthma and environmental allergies, such as hay fever
  • contact dermatitis, which is an allergic reaction to a substance touching the skin, such as soaps, scented products, or poison ivy
  • skin inflammation that accompanies the swelling of the legs.

Atopic dermatitis is the only skin condition for which Dupixent is approved.

Field

Every ad is a sales pitch, whether it uses real people or paid actors. Here we see real people banging drums in a band, playing piano or trombone, and cooking in the kitchen. A voiceover says “With less eczema, you can show more skin. So roll up your sleeves and help heal your skin from the inside out with Dupixent.” Field ? People with eczema can be embarrassed by it and try to hide it – and effective treatment means you don’t need to keep your skin covered.

We then learn that it is the “first treatment of its kind that continuously treats moderate to severe eczema, or atopic dermatitis, even between flare-ups”. The viewer sees an outstretched arm with a red rash that disappears in a second or two. Of course, that’s not what happens in real life; it can take weeks to see an improvement.

More perplexingly, the voiceover tells us that the drug “…is a biologic, not a cream or a steroid.” You may be wondering what a “biologic” drug is. Hold this question for further explanation below. “Many people taking Dupixent saw clear or almost clear skin and had significantly less itching. That’s a difference you can feel.

Side effects, warnings and slogan

The warnings may raise eyebrows. “Do not use if you are allergic to Dupixent. Serious allergic reactions may occur, including anaphylaxis, which is severe. Tell your doctor about any new or worsening eye problems, such as eye pain or disturbances in vision, or a parasitic infection If you are taking asthma medications, do not change or stop them without talking to your doctor.

Quickly, however, the ad shifts to a glowing tagline: “So help heal your skin from within” and recommends talking about Dupixent to “your eczema specialist.” This can be difficult: most people with eczema see their primary care physician, not a dermatologist.

What the ad gets right

It’s true that people with eczema can try to hide it, and effective therapy can be liberating, allowing them to worry less about others seeing their skin. Dupixent is indeed neither a cream nor a steroid, which are older and common treatments for eczema. And yes, Dupixent is the first treatment of its kind for eczema. It blocks a chemical called interleukin 4 (IL-4), which is thought to play an important role in this skin condition.

What else should you consider if you suffer from atopic dermatitis?

  • How is it generally treated? Mild cases of atopic dermatitis may react to skin moisturizers or medicated creams, gels, or ointments, some of which contain steroids. But it may not be effective for more severe eczema.
  • What is a biological? These drugs are made in a living system such as a microorganism, human or animal cells, or plant cells. These are often antibodies that block a substance in the body that is thought to be causing or contributing to disease. Since biologics are usually large molecules that would be destroyed during digestion if taken in tablet form, they are usually only available by injection. Dupixent is injected every two weeks.
  • Why are eye problems, parasites and asthma mentioned in the warnings? Eye inflammation was a side effect of the drug in studies leading to approval. IL-4 is considered a key part of our immune defense against parasitic infections, and a few study participants developed parasitic infections. As with asthma, Dupixent is an approved asthma treatment when combined with other medications. So, if you have asthma and it has improved while you are treating your atopic dermatitis, you may be tempted to reduce your other medications, but this is not safe without medical supervision.
  • What about the cost? Organic products are expensive. The annual price of this drug is around $40,000 per year. Even when covered by health insurance, co-payments and deductibles can make it an expensive treatment.
  • Does it work? Text on the screen indicates that 37% of adults and 24% of adolescents saw major improvement after four months of treatment, compared with less than 10% of people not taking Dupixent. That might sound great if you’re among the minority of people who have improved dramatically. Or it may seem a modest success for a systemic treatment with a significant risk of side effects and a high price.

The bottom line

Drug ads exist to sell a product. They should never be your primary source of health and treatment information. For this, consult your own health care providers and other reliable sources of information such as the FDA or NIH. Their main interest is to provide accurate information and to promote public health and drug safety, not to convince you to use a particular drug.

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