When inhalers aren’t enough: Using a biologic to manage IPF symptoms

Note: This column describes the author’s own experiences with Dupixent (dupilumab). Not everyone will have the same response to treatment. Consult your doctor before starting or stopping a therapy.

Idiopathic pulmonary fibrosis (IPF) is progressive, which means this lung disease inevitably worsens, making it increasingly difficult for patients to breathe. While therapies exist to slow disease progression, it can feel discouraging if they fail to do so.

Based on conversations with my pulmonologist, it’s my understanding that there are two main goals in IPF management. The first is to slow the progression of fibrosis, or scarring, in the lungs by using one of two anti-fibrotic medications approved by the U.S. Food and Drug Administration: Ofev (nintedanib) and Esbriet (pirfenidone). The second goal is to treat individual IPF symptoms, such as shortness of breath, hypoxia, and dry cough.

I take Ofev and have been prescribed a variety of therapies to help with symptom management. While discussing my breathlessness at a pulmonology appointment earlier this year, I was surprised to learn that my doctor felt I had tried all the usual treatments for it, including various inhalers and supplemental oxygen.

The number of inhalers I’d been using was difficult to manage, but I adapted. While it was inconvenient to have to stop my activities throughout the day, I thought my regimen was well managed — until my pulmonologist said otherwise. As a result, a conversation about other options ensued.

Recommended Reading

June 22, 2023 Columns by Charlene Marshall

Accepting that IPF exacerbations can be out of my control

My intro to biologics

At that point, I’d never heard of biologics, which are medications derived from living sources. According to GoodRx, they’re often administered via injection or infusion.

To clarify, there are no biologics approved to treat IPF; however, some of these medications may be used to ease symptoms of the disease.

In my case, my doctor prescribed Dupixent to help manage my breathlessness. This biologic is designed to reduce inflammation and, in pulmonary uses, improve lung function. I qualified to receive it because bloodwork confirmed my body was overproducing eosinophils, a type of white blood cell that increases inflammation to help the body fight off infections.

While I’m still learning about Dupixent, I do know that it’s made a difference for me. I’ve been taking it for several months now, but wanted to refrain from writing about it until I had a handle on how it affects me.

My experience with Dupixent

Like most biologics and rare disease medications, Dupixent is expensive, so I’m grateful to have it covered through my insurance plan here in Canada. Every month I receive a box with two injectables, and I inject one every other week.

So far, the drug has made my breathlessness more manageable. I feel optimistic that it will continue to improve my quality of life and perhaps even help prolong it. I’ll be interested to see if I’ve experienced any improvement in lung function at one of my upcoming pulmonary function tests.

Another positive is that I’ve experienced few side effects from Dupixent. Rare disease patients often deal with awful side effects from the medications used to treat our illnesses. For instance, adjusting to Ofev was a nightmare for me due to the side effects, and my team had to titrate the dosage several times before I could tolerate it. It’s a relief that this didn’t happen with the biologic.

I wanted to write a column about my experience with Dupixent to educate others about options for IPF symptom management. That said, the medication might not be for everyone. It’s important to speak with your doctor about your specific health concerns and treatment options.

Have you been prescribed Dupixent or another biologic? I’d love to hear about your experience!

Note: Pulmonary Fibrosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Fibrosis News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to pulmonary fibrosis.