Key findings of the study include:
- Dupilumab significantly reduced the adjusted annualized severe exacerbation rates during the 52-week treatment period.
- Significant reductions occurred in both early- and late-onset patients, though reductions were greater in the late-onset group.
- In early-onset patients, dupilumab reduced severe exacerbations by 38% when given at 200 mg and by 37% when given at 300 mg (P less than .001 vs. placebo). In late-onset patients, dupilumab reduced exacerbations by 64% and 69%, respectively (P less than .001 vs. placebo).
- reductions in exacerbation rates were greatest in patients with elevated blood eosinophils (150 cells/mcL or greater) or fractional exhaled nitric oxide (FeNO; 25 ppb or greater).
- In patients with early-onset asthma and elevated eosinophils, dupilumab reduced severe exacerbations by 50% when given at 200 mg and by 55% when given at 300 mg (P less than .001 vs. placebo).
- In late-onset patients with elevated eosinophils, dupilumab reduced exacerbations by 65% and 73%, respectively (P less than .001 vs. placebo).
- In patients with early-onset asthma and elevated FeNO, dupilumab reduced severe exacerbations by 56% when given at 200 mg and by 52% when given at 300 mg (P less than .001 vs. placebo). In late-onset patients with elevated FeNO, dupilumab reduced exacerbations by 79% and 71%, respectively (P less than .001 vs. placebo).
- Dupilumab also improved prebronchodilator forced expiratory volume in 1 second (pre-BD FEV1), compared with placebo, with similar results in early- and late-onset patients.
- In early-onset patients, the P values were less than .001 for both doses of dupilumab at weeks 12 and 52.
- In late-onset patients, the P values were less than .001 for the 300-mg dose at week 12 and the 200-mg dose at week 52, less than .01 for the 200-mg dose at week 12, and less than .05 for the 300-mg dose at week 52.
- The effects of dupilumab on pre-BD FEV1 were greatest in patients with elevated eosinophils or FeNO.
- At week 12, the P-value was less than .001 for both doses of dupilumab in early-onset patients with elevated eosinophils or FeNO. The P-value was less than .01 for both doses in late-onset patients with elevated eosinophils. And the P-value was less than .001 for both doses in late-onset patients with elevated FeNO.
Read Also: Add on Dupilumab reduces asthma exacerbationsThe bottom line of the study is -- Dupilumab is more effective in reducing severe asthma exacerbations in patients with late-onset asthma, but the drug’s effect on lung function appeared the same regardless of asthma onset.
More Information: "Dupilumab Reduces Severe Asthma Exacerbation Rate and Improves Lung Function Regardless of Age at Onset of Asthma: The Liberty Asthma Quest Study" published in the CHEST journal.
DOI: https://doi.org/10.1016/j.chest.2019.08.870
Journal Information: CHEST
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