Dupilumab reduced impact of severe exacerbations on lung function in patients with moderate-to-severe type 2 asthma

Alberto Papi, Jonathan Corren, Mario Castro, Christian Domingo, Linda Rogers, Kenneth R. Chapman, Daniel J. Jackson, Nadia Daizadeh, Nami Pandit-Abid, Rebecca Gall, Juby A. Jacob-Nara, Paul J. Rowe, Yamo Deniz, Benjamin Ortiz

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: Severe asthma exacerbations increase the risk of accelerated lung function decline. This analysis examined the effect of dupilumab on forced expiratory volume in 1 s (FEV1) in patients with moderate-to-severe asthma and elevated type 2 biomarkers from phase 3 LIBERTY ASTHMA QUEST (NCT02414854). Methods: Changes from baseline in pre- and post-bronchodilator (BD) FEV1 and 5-item Asthma Control Questionnaire (ACQ-5) scores were assessed in patients with elevated type 2 biomarkers at baseline (type 2–150/25: eosinophils ≥150 cells/μl and/or fractional exhaled nitric oxide [FeNO] ≥25 ppb; type 2–300/25: eosinophils ≥300 cells/μl and/or FeNO ≥25 ppb), stratified as exacerbators (≥1 severe exacerbation during the study) or non-exacerbators. Results: In exacerbators and non-exacerbators, dupilumab increased pre-BD FEV1 by Week 2 vs placebo; differences were maintained to Week 52 (type 2–150/25: LS mean difference (LSMD) vs placebo: 0.17 L (95% CI: 0.10–0.24) and 0.17 L (0.12–0.23); type 2–300/25: 0.22 L (0.13–0.30) and 0.21 L (0.15–0.28)), in exacerbators and non-exacerbators, respectively (p <.0001). Similar trends were seen for post-BD FEV1. Dupilumab vs placebo also showed significantly greater improvements in post-BD FEV1 0–42 days after first severe exacerbation in type 2–150/25 (LSMD vs placebo: 0.13 L [0.06–0.20]; p =.006) and type 2–300/25 (0.14 L [0.06–0.22]; p =.001) patients. ACQ-5 improvements were greater with dupilumab vs placebo in both groups. Conclusion: Dupilumab treatment led to improvements in lung function independent of exacerbations and appeared to reduce the impact of exacerbations on lung function in patients who experienced a severe exacerbation during the study.

Original languageEnglish
Pages (from-to)233-243
Number of pages11
JournalAllergy: European Journal of Allergy and Clinical Immunology
Volume78
Issue number1
DOIs
StatePublished - Jan 2023

Keywords

  • FEV
  • dupilumab
  • severe exacerbations
  • type 2 biomarkers

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