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Dupilumab AERD — RACP Adult Medicine MCQ

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HardRespiratoryDupilumab AERDRACP Adult Medicine

A patient has severe type-2 asthma plus uncontrolled atopic dermatitis despite optimised inhaled therapy and dermatological treatment. Eosinophils and FeNO are raised. Which biologic mechanism can address both conditions?

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Correct answer: C — Block IL-4 receptor alpha signalling with dupilumab

The best answer is “Block IL-4 receptor alpha signalling with dupilumab”. Dupilumab blocks IL-4 and IL-13 signalling through IL-4 receptor alpha and is effective for selected severe type-2 asthma and moderate-to-severe atopic dermatitis. Biologic selection follows specialist phenotyping and considers exacerbations, steroid dependence, eosinophils, FeNO, allergy, nasal polyps and comorbid disease; the other mechanisms do not target type-2 inflammation.

Reference: Australian Asthma Handbook: Specialist assessment and treatment for severe asthma: https://www.asthmahandbook.org.au/management/adults-and-adolescents/medication-management/specialist-assessment-and-treatment-for-severe-asthma-in-adults-and-adolescents