Dupilumab Improves QoL in Uncontrolled Asthma and Allergic Rhinitis

This article is part of Pulmonology Advisor‘s coverage of the American Academy of Allergy, Asthma & Immunology annual meeting, taking place in San Francisco, California. Our staff will report on medical research related to asthma, allergy, and other respiratory conditions, conducted by experts in the field. Check back regularly for more news from AAAAI 2019.

SAN FRANCISCO — Dupilumab is generally well tolerated and improves health-related quality of life associated with rhinoconjunctivitis in patients with uncontrolled moderate to severe asthma with comorbid allergic rhinitis, according to study findings presented at the 2019 Annual Scientific Meeting of the American College of Allergy, Asthma & Immunology held February 22-25 in San Francisco.

“Dupilumab, a fully human, VelocImmune^®-derived anti-interleukin (IL)-4Rα mAb [monoclonal antibody] that inhibits signaling of IL-4/IL-13, key drivers of type 2 inflammation, is approved for treatment of adults with inadequately controlled moderate-to-severe atopic dermatitis,” the researchers explained.

The findings were part of the phase 3 LIBERTY ASTHMA QUEST study (ClinicalTrials.gov Identifier: NCT02414854) that evaluated the quality of life in patients with moderate to severe asthma patients’ following dupilumab treatment. Patients with asthma (≥12 years) and self-reported comorbid allergic rhinitis were included in the study, and each patient completed the Standardized Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ[S]+12). Participants were on medium- to high-dose inhaled corticosteroids (ICS) and ≤2 additional controllers.

Researchers randomly assigned patients to receive either add-on dupilumab at 200/300 mg doses or a matched placebo every 2 weeks (q2w) for a total of 52 weeks. The RQLQ(S)+12 was completed at 12-and 52-week follow-up.

The addition of dupilumab 200/300 mg to ICS and controllers resulted in a greater improvement in mean baseline RQLQ(S)+12 score compared with placebo (baseline mean [SD], 1.90 [1.12] to 2.01 [1.16]) at 52 weeks (least squares mean difference, /–0.42 [95% CI, −0.61 to –0.24] vs –0.39 [95% CI, –0.56 to –0.21, respectively; P <.0001]).

Patients in the dupilumab group also experienced improvements in activities (–0.44 [95% CI, –0.68 to –0.21] vs –0.39 [95% CI, –0.61 to –0.16]; P <.001), sleep (–0.47 [95% CI, –0.69 to –0.25] vs –0.38 [95% CI, –0.59 to –0.17]), and eye symptoms (–0.37 [95% CI, –0.58 to –0.16] vs –0.39 [95% CI, –0.59 to –0.19]) scores from baseline to 52-week follow-up vs placebo.

Dupilumab at 200/300 mg was also associated with greater improvements in nasal symptoms compared with placebo at 12 weeks (–0.36 [95% CI, –0.56 to –0.16] vs –0.32 [95% CI, –0.51 to –0.13], respectively; P <.001) and 52 weeks (–0.61 [95% CI, –0.84 to –0.39] vs –0.55 [–0.76 to –0.33], respectively; P <.0001).

Injection site reaction was the most frequently reported adverse event, reported in more patients in the dupilumab (15%/18%) vs placebo (5%/10%) groups.

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Reference

Bousquet J, Maspero JF, Chipps BE, et al. Dupilumab consistently improves rhinoconjunctivitis-specific health-related quality of life in patients with uncontrolled, moderate-to-severe asthma and comorbid allergic rhinitis: results from the phase 3 LIBERTY ASTHMA QUEST study. Presented at: the Annual Meeting of the American Academy of Allergy, Asthma & Immunology; February 22-25, 2019; San Francisco, CA. Abstract 204.