Dupilumab improves asthma control in select patients

Patients with type 2 asthma and who are using high-dose inhaled corticosteroids (ICS) may fare well with dupilumab, which has been shown to reduce severe exacerbations and improve lung function and asthma control in a recent study.

The study was a post hoc analysis of the phase III QUEST study, which evaluated the efficacy of add-on dupilumab 200 and 300 mg every 2 weeks on the frequency of severe exacerbations, prebronchodilator forced expiratory volume in 1 s (FEV₁), and safety in patients with uncontrolled moderate-to-severe asthma.

In the current analysis, researchers analysed adjusted annualized severe exacerbation rates over the treatment period, with least squares (LS) mean change from baseline at week 12 in prebronchodilator FEV₁, and LS mean change from baseline at week 24 in 5-item Asthma Control Questionnaire (ACQ-5) scores in subgroups of patients receiving high-dose (>500 μg) ICS with baseline blood eosinophils ≥150 cells/μL and/or fractional exhaled nitric oxide ≥25 ppb.

Compared with placebo, dupilumab reduced exacerbations and improved prebronchodilator FEV₁ at week 12 and ACQ-5 at week 24 across patient subgroups defined by allergic phenotype (with vs without), comorbid chronic rhinosinusitis and/or nasal polyposis (with vs without), prebronchodilator FEV₁/forced vital capacity (<70 vs ≥70 percent), blood eosinophil level, exacerbation history, median baseline prebronchodilator FEV₁, age at asthma onset (≤40 vs >40 years), median FEV₁ reversibility, body mass index (<30 vs ≥30 kg/m²), and sex.

Furthermore, dupilumab proved effective in patients receiving medium-dose ICS.