dupilumab + mepolizumab

Dupilumab + mepolizumab is a combination of two monoclonal antibody biologics used off-label in select cases for the management of severe, treatment-refractory diseases characterized by eosinophilic inflammation and type 2 immune responses. Dupilumab is a fully human monoclonal IgG4 antibody that inhibits interleukin-4 (IL-4) and interleukin-13 (IL-13) signaling by binding to the IL-4Rα subunit, thereby reducing type 2 inflammation. Mepolizumab is a fully humanized monoclonal IgG1 kappa antibody that binds to interleukin-5 (IL-5), preventing its interaction with the IL-5 receptor and thus reducing eosinophil production and survival. This dual biologic approach has been reported in case studies for patients with overlapping or refractory conditions such as eosinophilic granulomatosis with polyangiitis (EGPA), chronic rhinosinusitis with nasal polyps (CRSwNP), severe asthma, and atopic dermatitis when monotherapy was insufficient[1][3][5]. The combination targets distinct but complementary pathways involved in allergic/eosinophilic diseases.