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Dupilumab is effective in type 2‐high asthma patients receiving high‐dose inhaled corticosteroids at baseline.
- Source :
- Allergy; Jan2021, Vol. 76 Issue 1, p269-280, 12p
- Publication Year :
- 2021
-
Abstract
- Background: Dupilumab blocks the shared receptor component for interleukin (IL)‐4/IL‐13, key drivers of type 2 inflammation. In phase 2b (NCT01854047) and phase 3 LIBERTY ASTHMA QUEST (NCT02414854), add‐on dupilumab 200/300 mg every 2 weeks (q2w) reduced severe exacerbations, improved prebronchodilator (pre‐BD) forced expiratory volume in 1 second (FEV1) and quality of life measures, and it was generally well tolerated in patients with uncontrolled, persistent (phase 2b), or moderate‐to‐severe (phase 3) asthma. Methods: In patients on high‐dose inhaled corticosteroids (ICS) with type 2‐high asthma (subgroups including baseline blood eosinophils ≥150/300 cells/µL and/or fractional exhaled nitric oxide [FeNO] ≥25 ppb), annualized severe exacerbation rates over the treatment period, changes from baseline in pre‐BD FEV1 and asthma control (5‐item asthma control questionnaire [ACQ‐5]) were analyzed. Results: In high‐dose ICS type 2‐high subgroups, dupilumab 200/300 mg q2w vs placebo in the phase 2b (24 weeks) and phase 3 (52 weeks) studies significantly reduced severe exacerbations by 55%‐69%/57%‐60% (all P<.05) and 53%‐69%/48%‐66% (all P <.001), respectively, except in patients with ≥ 300 eosinophils/µL in phase 2b study (24%/50% (P =.52/0.15). Across subgroups, pre‐BD FEV1 improved by 0.18‐0.22 L/0.19‐0.24 L (all P <.05) and 0.23‐0.36 L/0.15‐0.25 L (all P <.01) and ACQ‐5 scores were reduced by 0.46‐0.55/0.47‐0.85 (all P <.05) and 0.38‐0.50/0.24‐0.30 (all P <.05), respectively, except dupilumab 200 mg q2w in phase 2b in patients with FeNO ≥ 25 ppb (0.41; P =.09). Dupilumab was also effective in patients taking medium‐dose ICS. Conclusion: Dupilumab significantly reduced severe exacerbations and improved lung function and asthma control in patients with type 2‐high asthma on high‐dose ICS at baseline. [ABSTRACT FROM AUTHOR]
- Subjects :
- ASTHMATICS
CORTICOSTEROIDS
INTERLEUKIN receptors
NITRIC oxide
ASTHMA
Subjects
Details
- Language :
- English
- ISSN :
- 01054538
- Volume :
- 76
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Allergy
- Publication Type :
- Academic Journal
- Accession number :
- 147967991
- Full Text :
- https://doi.org/10.1111/all.14611