Dupilumab Associated With Reduced Severe Outpatient Asthma Exacerbation Rates

This article is part of Pulmonology Advisor’s coverage of the CHEST Virtual 2020 meeting.

In patients with type 2 asthma, dupilumab was associated with significantly lower annualized outpatient asthma exacerbation rates and lower total number of days using systemic corticosteroids, according to research presented at the CHEST Annual Meeting held virtually October 18 to 21.

Researchers conducted a post hoc analysis of the phase 3 LIBERTY ASTHMA QUEST study (ClinicalTrials.gov Identifier: NCT02414854) to determine the effect of dupilumab vs placebo on severe outpatient asthma exacerbations, the total number of days on systemic corticosteroids, and the cumulative dose of systemic corticosteroids associated with severe outpatient exacerbations in patients with type 2 asthma (baseline blood eosinophils ≥150 cells/µL or fractional exhaled nitric oxide ≥25 ppb).  

Dupilumab 200 mg reduced the annualized severe outpatient asthma exacerbation rate by 55% in the 1515 patients included (estimate, 0.4; 95% CI, 0.3-0.5 vs placebo estimate, 0.8; 95% CI, 0.7-1.0; P <.0001). Meanwhile, exacerbation rates were reduced by 61% with dupilumab 300 mg (0.4; 95% CI, 0.3-0.5 vs placebo, 1.0; 95% CI, 0.8-1.3; P <.0001). With dupilumab 200/300 mg, the annualized total number of days of systemic corticosteroid use was 13.7/12.4 days vs 19.6/22.5 days with matched placebos.

Furthermore, the average daily dose of systemic corticosteroids during an exacerbation with dupilumab 200/300 mg was 27.6/30 mg vs 30.0/30.0 mg with matched placebo. The cumulative dose of systemic corticosteroids with dupilumab 200/300 mg was 280.0/250.0 mg vs 350.0/350.0 mg with matched placebo.

“Dupilumab may benefit [patients with] asthma with elevated type 2 biomarkers by reducing the total number of days on [systemic corticosteroids], as well as cumulative [systemic corticosteroid] dose,” the researchers wrote.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

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Reference

Canonica GW, Zeiger R, Castro M, et al. Dupilumab reduces severe outpatient asthma exacerbations, cumulative dose, and total number of days of systemic corticosteroid use among patients with moderate-to-severe type-2 asthma. Presented at: the CHEST Virtual Annual Meeting; October 18-21, 2020. Abstract 1810.