Would you stop Dupixent in an asthma patient who has good asthma control and notes improvement in loss of smell, but shows notable eosinophil elevation after 4-5 doses of the medication?

Transient eosinophilia has been reported in patients treated with Dupixent, likely related to downregulation of eotaxin and adhesion molecules resulting in impaired eosinophil migration into the tissues (Castro et al., PMID 29782217, Olaguibel et al., PMID 35522053). This phenomenon is typically see...

I would likely not stop Dupixent. This patient appears to be doing well clinically based on the question stem. I would have liked to see more pre-dupilumab treatment eosinophil counts (AEC) since there can be day-to-day variability in the AEC, and often we find high AEC values in patients with sever...

If the patient benefited significantly from Dupixent, there is no reason to believe that they would also benefit from other monocolnals such as mepolizumab or benralizumab. Generally speaking, my "cut off" for level of eosinophilia that makes me want to do something now is 1500/mm3. So I would eithe...

Transient eosinophilia been noted in patients being treated with dupilumab for asthma, chronic rhinosinusitis with nasal polyposis, and atopic dermatitis. In a review of 11 dupilumab clinical trials, Weschler et al reported that an increase in blood eosinophil counts was not seen in patients being t...