Dupilumab Improves Asthma Control and Lung Function in Patients with Insufficient Outcome During Previous Antibody Therapy

Background Biological treatments directed against IgE and IL-5 have largely improved outcomes for patients with severe type 2–high asthma. However, a fraction of patients with severe asthma show insufficient treatment outcome under anti-IgE and anti–IL-5/IL-5 receptor α antibodies. Objective To evaluate whether switching to dupilumab was of benefit in patients with insufficient outcome under previous anti-IgE or anti–IL-5/IL-5 receptor α therapy. Methods We retrospectively analyzed 38 patients who were switched to dupilumab from a previous anti-IgE or anti–IL-5/IL-5 receptor α medication because of insufficient outcome. We defined response criteria after 3 to 6 months as an improvement in at least 1 of the following criteria without deterioration in the other criteria, comparing values under dupilumab with values under previous antibody therapy: (1) increase of 3 or more in Asthma Control Test score, (2) 50% or more reduction in oral corticosteroid dose, and (3) FEV1 improvement greater than or equal to 150 mL, and classified patients as responders and nonresponders. Results Switch to dupilumab led to a response in 76% of patients. In the total cohort, Asthma Control Test score increased by a mean of 2.9 (P Conclusions Altogether, we show that a switch to dupilumab in patients with insufficient outcome under previous biological therapy was effective in most patients.