Dupilumab is effective in type 2-high asthma patients receiving high-dose inhaled corticosteroids at baseline.
asthma control
exacerbations
inhaled corticosteroids
moderate-to-severe asthma
prebronchodilator FEV1
Journal
Allergy
ISSN: 1398-9995
Titre abrégé: Allergy
Pays: Denmark
ID NLM: 7804028
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
24
04
2020
revised:
18
08
2020
accepted:
26
08
2020
pubmed:
4
10
2020
medline:
15
5
2021
entrez:
3
10
2020
Statut:
ppublish
Résumé
Dupilumab blocks the shared receptor component for interleukin (IL)-4/IL-13, key drivers of type 2 inflammation. In phase 2b (NCT01854047) and phase 3 LIBERTY ASTHMA QUEST (NCT02414854), add-on dupilumab 200/300 mg every 2 weeks (q2w) reduced severe exacerbations, improved prebronchodilator (pre-BD) forced expiratory volume in 1 second (FEV In patients on high-dose inhaled corticosteroids (ICS) with type 2-high asthma (subgroups including baseline blood eosinophils ≥150/300 cells/µL and/or fractional exhaled nitric oxide [FeNO] ≥25 ppb), annualized severe exacerbation rates over the treatment period, changes from baseline in pre-BD FEV In high-dose ICS type 2-high subgroups, dupilumab 200/300 mg q2w vs placebo in the phase 2b (24 weeks) and phase 3 (52 weeks) studies significantly reduced severe exacerbations by 55%-69%/57%-60% (all P<.05) and 53%-69%/48%-66% (all P < .001), respectively, except in patients with ≥ 300 eosinophils/µL in phase 2b study (24%/50% (P = .52/0.15). Across subgroups, pre-BD FEV Dupilumab significantly reduced severe exacerbations and improved lung function and asthma control in patients with type 2-high asthma on high-dose ICS at baseline.
Sections du résumé
BACKGROUND
Dupilumab blocks the shared receptor component for interleukin (IL)-4/IL-13, key drivers of type 2 inflammation. In phase 2b (NCT01854047) and phase 3 LIBERTY ASTHMA QUEST (NCT02414854), add-on dupilumab 200/300 mg every 2 weeks (q2w) reduced severe exacerbations, improved prebronchodilator (pre-BD) forced expiratory volume in 1 second (FEV
METHODS
In patients on high-dose inhaled corticosteroids (ICS) with type 2-high asthma (subgroups including baseline blood eosinophils ≥150/300 cells/µL and/or fractional exhaled nitric oxide [FeNO] ≥25 ppb), annualized severe exacerbation rates over the treatment period, changes from baseline in pre-BD FEV
RESULTS
In high-dose ICS type 2-high subgroups, dupilumab 200/300 mg q2w vs placebo in the phase 2b (24 weeks) and phase 3 (52 weeks) studies significantly reduced severe exacerbations by 55%-69%/57%-60% (all P<.05) and 53%-69%/48%-66% (all P < .001), respectively, except in patients with ≥ 300 eosinophils/µL in phase 2b study (24%/50% (P = .52/0.15). Across subgroups, pre-BD FEV
CONCLUSION
Dupilumab significantly reduced severe exacerbations and improved lung function and asthma control in patients with type 2-high asthma on high-dose ICS at baseline.
Identifiants
pubmed: 33010038
doi: 10.1111/all.14611
pmc: PMC7820970
doi:
Substances chimiques
Adrenal Cortex Hormones
0
Anti-Asthmatic Agents
0
Antibodies, Monoclonal
0
Antibodies, Monoclonal, Humanized
0
dupilumab
420K487FSG
Banques de données
ClinicalTrials.gov
['NCT02414854', 'NCT01854047']
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
269-280Informations de copyright
© 2020 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.
Références
Thorax. 1992 Feb;47(2):76-83
pubmed: 1549827
Allergy. 2021 Jan;76(1):269-280
pubmed: 33010038
Allergy. 2014 Jul;69(7):817-27
pubmed: 24773466
J Exp Med. 2006 Jun 12;203(6):1435-46
pubmed: 16702603
Chest. 2016 Oct;150(4):799-810
pubmed: 27018175
N Engl J Med. 2018 Jun 28;378(26):2475-2485
pubmed: 29782224
J Asthma. 2010 Mar;47(2):124-30
pubmed: 20170317
Science. 1995 Oct 13;270(5234):286-90
pubmed: 7569976
J Allergy Clin Immunol. 1998 Oct;102(4 Pt 2):S17-22
pubmed: 9798720
Am J Respir Crit Care Med. 2019 Jun 15;199(12):1471-1477
pubmed: 30645143
Clin Exp Allergy. 2012 May;42(5):650-8
pubmed: 22251060
Lancet Respir Med. 2017 May;5(5):390-400
pubmed: 28395936
N Engl J Med. 2018 Jun 28;378(26):2486-2496
pubmed: 29782217
Allergy. 2020 May;75(5):1188-1204
pubmed: 31838750
Proc Natl Acad Sci U S A. 2014 Apr 8;111(14):5153-8
pubmed: 24706856
Respir Med. 2005 May;99(5):553-8
pubmed: 15823451
Adv Ther. 2018 May;35(5):737-748
pubmed: 29725983
Allergy. 2008 Apr;63 Suppl 86:8-160
pubmed: 18331513
N Engl J Med. 2013 Jun 27;368(26):2455-66
pubmed: 23688323
N Engl J Med. 2014 Sep 25;371(13):1198-207
pubmed: 25199059
Am J Respir Crit Care Med. 2013 Apr 15;187(8):804-11
pubmed: 23471469
Lancet. 2012 Aug 18;380(9842):651-9
pubmed: 22901886
Lancet Respir Med. 2015 May;3(5):355-66
pubmed: 25736990
Am J Respir Crit Care Med. 2004 Oct 15;170(8):836-44
pubmed: 15256389
Thorax. 2018 Feb;73(2):116-124
pubmed: 28918400
J Investig Allergol Clin Immunol. 2013;23(2):76-88; quiz 1 p. follow 88
pubmed: 23654073
Lancet. 2016 Oct 29;388(10056):2115-2127
pubmed: 27609408
Expert Rev Clin Immunol. 2017 May;13(5):425-437
pubmed: 28277826
Thorax. 2019 Apr;74(4):417-418
pubmed: 30315084
Lancet. 2016 Oct 29;388(10056):2128-2141
pubmed: 27609406
Nat Rev Immunol. 2015 Jan;15(1):57-65
pubmed: 25534623
Proc Natl Acad Sci U S A. 2014 Apr 8;111(14):5147-52
pubmed: 24706858
Lancet. 2016 Jul 2;388(10039):31-44
pubmed: 27130691
Br Med J. 1973 Oct 27;4(5886):205-7
pubmed: 4357135