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Dupilumab side effects: what 478,943 FDA adverse event reports show

Dupilumab · Dupixent · 1,268 reaction terms · 1,231,391 drug–reaction co-reports · data 2026-09-14
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Drug class

Interleukin-4 Receptor alpha Antagonist

FDA label (Established Pharmacologic Class)

Brand names

Dupixent

openFDA label

Who reports

478,943 reports · 11% serious · 2,193 with death outcome · 61% female

openFDA FAERS counts, all years, deduplication not applied

Used for

DUPIXENT is an interleukin-4 receptor alpha antagonist indicated: Atopic Dermatitis for the treatment of adult and pediatric patients aged 6 months and older with moderate-to-severe AD whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable. DUPIXENT can be used with or without topical corticosteroids.

FDA label, Indications and Usage

What it is

Dupilumab, an interleukin-4 receptor alpha antagonist, is a human monoclonal antibody of the IgG4 subclass that binds to the IL-4Rα subunit and inhibits IL-4 and IL-13 signaling. Dupilumab has an approximate molecular weight of 147 kDa.

FDA label, Description section

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled adverse reaction 3Labeled (related wording) 5Likely indication confounding 6Reporting / coding artifact 3Not in label — unassessed 23
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,228 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Rebound atopic dermatitis2,00512,087.9
5,755.2–25,388.6ROR 12,138.7 · calibrated p 5e-26 ✓
43.0 EB05 41.5 · IC025 +5.3
3/3 methods agree
Not in label — unassessedserious n=86 · 90% cliniciannot reported in cached trials
Rebound eczema2,0102,925.0
2,027.4–4,220.2ROR 2,937.4 · calibrated p 5e-22 ✓
42.6 EB05 41.0 · IC025 +5.3
3/3 methods agree
Not in label — unassessedserious n=97not reported in cached trials
Dermatitis atopic45,026444.6
430.9–458.7ROR 490.6 · calibrated p 7e-14 ✓
39.5 EB05 39.2 · IC025 +5.3
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
age-adj. PRR 377.5 · serious n=1,831NCT01949311: 6/2,677 (0.2%) on Dupilumab (serious AE)
Eosinophilic oesophagitis1,830106.7
97.9–116.3ROR 107.1 · calibrated p 7e-8 ✓
30.9 EB05 29.8 · IC025 +4.9
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious n=220not reported in cached trials
Neurodermatitis2,35691.8
85.4–98.7ROR 92.3 · calibrated p 2e-7 ✓
29.6 EB05 28.6 · IC025 +4.8
3/3 methods agree
Not in label — unassessedserious n=188not reported in cached trials
Eczema infantile5884.4
54.0–131.8ROR 84.4 · calibrated p 1e-6 ✓
28.6 EB05 22.9 · IC025 +4.1
3/3 methods agree
Not in label — unassessed♀ 0% (drug 61%)not reported in cached trials
Periorbital irritation20173.8
58.7–92.8ROR 73.8 · calibrated p 1e-6 ✓
27.4 EB05 24.4 · IC025 +4.5
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Exposure via skin contact13,93470.1
68.3–72.1ROR 72.2 · calibrated p 1e-6 ✓
27.0 EB05 26.6 · IC025 +4.7
3/3 methods agree
Reporting / coding artifactage-adj. PRR 69.8 · serious n=486not reported in cached trials
Skin weeping1,94661.4
57.3–65.9ROR 61.7 · calibrated p 4e-6 ✓
25.6 EB05 24.7 · IC025 +4.6
3/3 methods agree
Not in label — unassessedserious n=166not reported in cached trials
Eczema eyelids29754.7
46.1–65.0ROR 54.8 · calibrated p 9e-6 ✓
24.4 EB05 22.1 · IC025 +4.4
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Eyelid skin dryness64353.1
47.3–59.6ROR 53.2 · calibrated p 1e-5 ✓
24.1 EB05 22.5 · IC025 +4.4
3/3 methods agree
Not in label — unassessedserious n=27not reported in cached trials
Eczema26,62648.8
48.0–49.7ROR 51.6 · calibrated p 1e-5 ✓
23.2 EB05 22.9 · IC025 +4.5
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 45.3 · serious PRR 21.4NCT01949311: 2/2,677 (0.1%) on Dupilumab (serious AE)
Nasal polypectomy7541.6
30.3–57.3ROR 41.7 · calibrated p 6e-5 ✓
21.4 EB05 17.6 · IC025 +3.9
3/3 methods agree
Not in label — unassessed♀ 0% (drug 61%)not reported in cached trials
Periorbital inflammation10738.3
29.5–49.7ROR 38.3 · calibrated p 9e-5 ✓
20.5 EB05 17.4 · IC025 +3.9
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Chronic rhinosinusitis with nasal polyps6537.1
26.6–51.7ROR 37.1 · calibrated p 1e-4 ✓
20.1 EB05 16.3 · IC025 +3.7
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
–not reported in cached trials
Nasal polyps2,08332.8
31.0–34.7ROR 33.0 · calibrated p 2e-4 ✓
18.9 EB05 18.2 · IC025 +4.2
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious n=185not reported in cached trials
Sleep disorder due to a general medical condition6,83831.6
30.7–32.6ROR 32.1 · calibrated p 2e-4 ✓
18.5 EB05 18.1 · IC025 +4.2
3/3 methods agree
Not in label — unassessedage-adj. PRR 37.0 · serious PRR 16.4not reported in cached trials
Unintentional use for unapproved indication24730.6
26.0–36.0ROR 30.6 · calibrated p 3e-4 ✓
18.1 EB05 16.3 · IC025 +3.9
3/3 methods agree
Not in label — unassessedserious n=41not reported in cached trials
Mood disorder due to a general medical condition9029.9
22.8–39.2ROR 29.9 · calibrated p 3e-4 ✓
17.9 EB05 15.0 · IC025 +3.7
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Eyelid rash36627.3
24.0–31.2ROR 27.4 · calibrated p 4e-4 ✓
17.0 EB05 15.6 · IC025 +3.9
3/3 methods agree
Not in label — unassessedserious n=21not reported in cached trials
Skin fissures7,19426.5
25.8–27.3ROR 26.9 · calibrated p 5e-4 ✓
16.7 EB05 16.4 · IC025 +4.0
3/3 methods agree
Not in label — unassessedage-adj. PRR 24.5 · serious n=412not reported in cached trials
Product dose omission in error9,76724.6
24.0–25.2ROR 25.1 · calibrated p 7e-4 ✓
15.9 EB05 15.7 · IC025 +4.0
3/3 methods agree
Reporting / coding artifactage-adj. PRR 27.7 · serious PRR 23.2not reported in cached trials
Ocular surface disease9624.6
19.1–31.6ROR 24.6 · calibrated p 9e-4 ✓
15.8 EB05 13.3 · IC025 +3.5
3/3 methods agree
Not in label — unassessedserious n=95 · ♀ 0% (drug 61%) · 100% cliniciannot reported in cached trials
Lack of injection site rotation62424.5
22.2–27.0ROR 24.5 · calibrated p 8e-4 ✓
15.8 EB05 14.8 · IC025 +3.8
3/3 methods agree
Not in label — unassessedserious n=31not reported in cached trials
Oesophageal food impaction18322.8
19.1–27.4ROR 22.9 · calibrated p 0.001 ✓
15.1 EB05 13.4 · IC025 +3.6
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=183NCT02134028: 1/517 (0.2%) control (serious AE)
Conjunctivitis5,87220.2
19.6–20.8ROR 20.4 · calibrated p 0.002 ✓
14.0 EB05 13.7 · IC025 +3.8
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 13.7 · serious PRR 15.1NCT01949311: 1/2,677 (0.0%) on Dupilumab (serious AE)
Perioral dermatitis19420.0
16.8–23.7ROR 20.0 · calibrated p 0.002 ✓
13.8 EB05 12.3 · IC025 +3.5
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Eyelid margin crusting88419.7
18.1–21.3ROR 19.7 · calibrated p 0.002 ✓
13.7 EB05 13.0 · IC025 +3.7
3/3 methods agree
Not in label — unassessedserious n=87not reported in cached trials
Eyelids pruritus93919.0
17.6–20.5ROR 19.1 · calibrated p 0.002 ✓
13.4 EB05 12.7 · IC025 +3.6
3/3 methods agree
Not in label — unassessedserious n=66not reported in cached trials
Idiopathic urticaria29918.7
16.4–21.5ROR 18.8 · calibrated p 0.003 ✓
13.3 EB05 12.0 · IC025 +3.5
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
–not reported in cached trials
Eye pruritus9,98618.7
18.3–19.1ROR 19.1 · calibrated p 0.002 ✓
13.3 EB05 13.0 · IC025 +3.7
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 21.3 · serious PRR 18.4NCT01949311: 1/2,677 (0.0%) on Dupilumab (serious AE)
Skin haemorrhage4,21417.7
17.1–18.4ROR 17.9 · calibrated p 0.003 ✓
12.8 EB05 12.5 · IC025 +3.6
3/3 methods agree
Not in label — unassessedage-adj. PRR 18.0 · serious n=330not reported in cached trials
Therapeutic response shortened9,22917.6
17.1–18.0ROR 17.9 · calibrated p 0.003 ✓
12.7 EB05 12.5 · IC025 +3.6
3/3 methods agree
Reporting / coding artifactage-adj. PRR 23.9 · serious PRR 10.4not reported in cached trials
Dyshidrotic eczema19917.4
14.8–20.6ROR 17.4 · calibrated p 0.004 ✓
12.6 EB05 11.2 · IC025 +3.4
3/3 methods agree
Not in label — unassessed–NCT02134028: 1/1,013 (0.1%) on Dupilumab; 1/19 (5.3%) control
Eyelid exfoliation22317.0
14.6–19.9ROR 17.0 · calibrated p 0.004 ✓
12.4 EB05 11.1 · IC025 +3.4
3/3 methods agree
Not in label — unassessed–not reported in cached trials

Clinical concept groups

MedDRA splits one clinical problem across several terms (e.g. "neutropenia", "neutrophil count decreased", "agranulocytosis"), which dilutes term-level signals. These rows count reports with any term in a concept group (an exact union, not a sum), compared with all other drugs. Groups are hand-built and listed in the methods.

ConceptReportsPRR 95% CIReading
Opportunistic infection2,2300.70.7–0.7lower than other drugs
Serious infection9,6190.50.5–0.6lower than other drugs
Tendon disorder3460.40.4–0.4lower than other drugs
Anaphylaxis / angioedema1,0140.30.3–0.4lower than other drugs
Fall / fracture2,9710.30.3–0.3lower than other drugs
Depression2,1790.30.3–0.3lower than other drugs
Stroke1,1450.20.2–0.2lower than other drugs
Malignancy1,7050.20.2–0.2lower than other drugs
Venous thromboembolism8170.20.2–0.2lower than other drugs
Arrhythmia / qt7050.20.1–0.2lower than other drugs
Pancreatitis2880.20.1–0.2lower than other drugs
Myocardial infarction6930.10.1–0.2lower than other drugs
Heart failure5810.10.1–0.2lower than other drugs
Hyperglycaemia / diabetes1,0600.10.1–0.1lower than other drugs
Seizure5580.10.1–0.1lower than other drugs
Interstitial lung disease2640.10.1–0.1lower than other drugs

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Dupilumab as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (7 of 40 signal terms matched).

Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Pruritus (itching)58,6927.9
7.8–7.9ROR 8.8 · calibrated p 0.048 ✓
6.8 EB05 6.8 · IC025 +2.8
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 8.2 · serious PRR 5.6NCT01949311: 1/2,677 (0.0%) on Dupilumab (serious AE)
Dermatitis atopic45,026444.6
430.9–458.7ROR 490.6 · calibrated p 7e-14 ✓
39.5 EB05 39.2 · IC025 +5.3
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
age-adj. PRR 377.5 · serious n=1,831NCT01949311: 6/2,677 (0.2%) on Dupilumab (serious AE)
Product use in unapproved indication41,2258.7
8.6–8.8ROR 9.4 · calibrated p 0.039 ✓
7.4 EB05 7.3 · IC025 +2.9
3/3 methods agree
Reporting / coding artifactage-adj. PRR 9.0 · serious PRR 9.2not reported in cached trials
Rash38,6294.2
4.1–4.2ROR 4.5 · calibrated p 0.301
3.9 EB05 3.9 · IC025 +1.9
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 3.9 · serious PRR 3.2NCT02134028: 1/517 (0.2%) control (serious AE)
Injection site pain (pain where injected)36,7075.9
5.8–6.0ROR 6.3 · calibrated p 0.132
5.3 EB05 5.2 · IC025 +2.4
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 5.6 · serious PRR 10.1NCT01949311: 2/2,677 (0.1%) on Dupilumab (serious AE)
Drug ineffective (drug did not work)30,0151.0
1.0–1.0ROR 1.0 · calibrated p 0.305
1.0 EB05 1.0 · IC025 -0.0
PRR-only: not supported by EBGM or IC
Reporting / coding artifactage-adj. PRR 1.1 · serious PRR 1.1not reported in cached trials
Eczema26,62648.8
48.0–49.7ROR 51.6 · calibrated p 1e-5 ✓
23.2 EB05 22.9 · IC025 +4.5
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 45.3 · serious PRR 21.4NCT01949311: 2/2,677 (0.1%) on Dupilumab (serious AE)
Product dose omission issue25,2954.2
4.1–4.2ROR 4.4 · calibrated p 0.318
3.9 EB05 3.8 · IC025 +1.9
3/3 methods agree
Reporting / coding artifactage-adj. PRR 4.3 · serious PRR 5.0not reported in cached trials
Condition aggravated20,6863.1
3.1–3.2ROR 3.2 · calibrated p 0.552
3.0 EB05 3.0 · IC025 +1.6
3/3 methods agree
Reporting / coding artifactage-adj. PRR 2.9 · serious PRR 2.9not reported in cached trials
Arthralgia (joint pain)19,2972.1
2.1–2.1ROR 2.1 · calibrated p 0.984
2.0 EB05 2.0 · IC025 +1.0
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 2.0 · serious PRR 2.4NCT01949311: 1/2,677 (0.0%) on Dupilumab (serious AE)
Inappropriate schedule of product administration18,5975.0
5.0–5.1ROR 5.2 · calibrated p 0.214
4.6 EB05 4.5 · IC025 +2.2
3/3 methods agree
Reporting / coding artifactage-adj. PRR 5.2 · serious PRR 5.0not reported in cached trials
Asthma16,1537.2
7.1–7.3ROR 7.4 · calibrated p 0.083
6.3 EB05 6.2 · IC025 +2.6
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
age-adj. PRR 7.7 · serious PRR 10.0NCT01949311: 3/2,677 (0.1%) on Dupilumab (serious AE)
Accidental exposure to product15,8188.1
7.9–8.2ROR 8.3 · calibrated p 0.059
6.9 EB05 6.8 · IC025 +2.8
3/3 methods agree
Reporting / coding artifactage-adj. PRR 8.4 · serious PRR 13.7not reported in cached trials
Skin exfoliation14,7579.3
9.1–9.4ROR 9.5 · calibrated p 0.038 ✓
7.8 EB05 7.7 · IC025 +2.9
3/3 methods agree
Not in label — unassessedage-adj. PRR 7.8 · serious PRR 8.8not reported in cached trials

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Dupilumab?

In FDA FAERS, the most frequently co-reported reaction terms for Dupilumab are pruritus, dermatitis atopic, rash, injection site pain, eczema, dry skin. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Dupilumab have an FDA boxed warning?

No. The FDA label retrieved for Dupilumab has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Dupilumab causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.