X ray

[Madbiker1]

I had a review a week or so back. Been on dupilimab for 18 months or so - on home care so I administer it myself.

I explained that I now cough a lot. My FeNo was high ( usually in three figures) I did spirometry and a blood test.

Just been called by a pharamcist - consultant wants me to have a chest x ray as my eosinophils are high - this and the high FeNo have been enough for somebody to want to look a bit deeper.

[Pipsqueak77]

Hi Madbiker1

Dupilumab can potentially have a side effect of elevating eosinophils to a very high level. Obviously this is not so good for your asthma control and can cause problems in other parts of the body too.

My cons keeps an eye on my levels as sometimes my eos take a hike for no apparent reason and I end up in hospital.

If it keeps happening and the levels get too high I will need to change biologic.

Maybe this is what’s happening with you too??

Hope you get some answers.

😊👍

[Madbiker1 in reply to Pipsqueak77]

Thank you for your reply.I developed asthma in my 40's - had nasal polyps first and I still have sinus issues.

My worry is that my asthma may potentially turn into EGPA.

[Pipsqueak77 in reply to Madbiker1]

Hi

Well i guess you will have to have a chat with your hospital team about your worries. However if you look at the potential side effects of Dupilumab, raised eosinophils is one of them. This would mimic EGPA.

I find that my eos are generally ok on Dup but can just sky rocket for no apparent reason. . This is the Dup so we are keeping an eye out.

Maybe try a different biologic going forward?

😊

[runcyclexcski]

May I ask how high your Eos count was?

I had to stop Dupi after 4 months: it did not do much to my asthma, and made my joints ache. I understand everyone is different, and it works for many folks here.

[Snazzyjack in reply to runcyclexcski]

me too, i could barely move

[Madbiker1]

2.83 IIRC.

[Yankie]

I hope you are better now. It sounds a possible eosinophilic asthma to me. What do they say now?

[Poobah]

Not everyone gets on with Dupilumab, but there are other biologics that treat eosinophilic asthma and nasal polyps (also caused by high eosinophils). Mepolizumab (Nucala) and Benralizumab (Fasenra) are alternatives available in the UK. If your consultant considered you qualify for Dupilumab, they will probably be open to you trying an alternative biologic.