Dupilumab Reduces Severe Asthma Exacerbations, With/Without Reduction in FeNO

Dupilumab significantly reduced severe asthma exacerbations and improved prebronchodilator forced expiratory volume in 1 second (FEV₁) in patients with baseline fractional exhaled nitric oxide (FeNO) greater than or equal to 25 ppb with/without substantial FeNO reduction, according to a post hoc analysis presented at the American College of Allergy, Asthma & Immunology (ACAAI) Annual Scientific Meeting, held virtually from November 13 to 15.

In the phase 3 LIBERTY ASTHMA QUEST study (ClinicalTrials.gov Identifier: NCT02414854), add-on dupilumab 200 mg and 300 mg every 2 weeks vs placebo significantly reduced severe exacerbations, improved prebronchodilator FEV₁, and was generally well tolerated in patients with uncontrolled, moderate to severe asthma. Rapid FeNO reduction has been shown to predict treatment response in patients with asthma; therefore, researchers conducted a post hoc analysis of LIBERTY ASTHMA QUEST to assess dupilumab efficacy in patients with baseline FeNO greater than or equal to 25 ppb with/without substantial FeNO reduction.

Substantial reduction in FeNO was defined as a 20% or more reduction in patients with FeNO greater than or equal to 50 ppb at baseline, or a more than 10 ppb reduction in patients with FeNO less than 50 ppb at baseline.

Significantly more patients treated with dupilumab (70.2%) than patients given placebo (38.9%) achieved substantial FeNO reduction (odds ratio, 4.19; 95% CI, 3.11-5.64; P <.0001). The percentage decrease in FeNO from baseline was overall higher in patients treated with dupilumab vs placebo with/without substantial FeNO reduction. In addition, dupilumab significantly reduced severe exacerbations vs placebo, and improved prebronchodilator FEV₁ (least squares mean difference 0.20 [95% CI, 0.12-0.28]/0.17 [95% CI, 0.09-0.26]) in patients with/without substantial FeNO reduction (P <.001 for all).   

“Dupilumab vs placebo significantly reduced severe exacerbations and improved prebronchodilator FEV₁ in patients with baseline FeNO ≥ 25 ppb with/without substantial FeNO reduction,” the researchers concluded.

Disclosure: This clinical trial was supported by Sanofi. Please see the original reference for a full list of authors’ disclosures.

Reference

Halpin D, Korn S, Matucci A, et al. Efficacy of dupilumab in patients with asthma with/without substantial reduction in fractional exhaled nitric oxide. Presented at: the American College of Allergy, Asthma & Immunology (ACAAI) Annual Scientific Meeting (Virtual Experience); November 13-15, 2020. Abstract P221.