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https://swslhd.intersearch.com.au/swslhdjspui/handle/1/601| Title: | Efficacy of dupilumab in patients with moderate-to-severe asthma and persistent airflow obstruction |
| Authors: | Hanania, N. A. Castro, M. Bateman, E. Pavord, I. D. Papi, A. FitzGerald, J. M. Maspero, J. F. Katelaris, C. H. Singh, D. Daizadeh, N. Altincatal, A. Pandit-Abid, N. Soler, X. Siddiqui, S. Laws, E. Jacob-Nara, J. A. Rowe, P. J. Lederer, D. J. Hardin, M. Deniz, Y. |
| SWSLHD Author: | Katelaris, Constance H. Katelaris, Constance H. |
| Affiliates: | Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, Texas, United States University of Kansas School of Medicine, Kansas City, Kansas University of Cape Town Lung Institute, Cape Town, South Africa NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom Respiratory Medicine Unit, University of Ferrara, S. Anna University Hospital, Ferrara, Italy University of British Columbia, Vancouver, BC, Canada Fundaci���������n CIDEA, Buenos Aires, Argentina Campbelltown Hospital, Campbelltown, NSW, Australia, Western Sydney University, SydneyNSW, Australia Medicines Evaluation Unit, University of Manchester, Manchester University Foundation Trust NHS Hospital, Manchester, United Kingdom Sanofi, Cambridge, Massachusetts, United States Sanofi, Bridgewater, New Jersey Regeneron Pharmaceuticals, Inc, Tarrytown, NY, United States |
| Department: | Campbelltown Hospital, Department of Medicine, Immunology and Allergy Unit Campbelltown Hospital, Department of Immunology and Allergy |
| Issue Date: | 2023 |
| Journal: | Annals of Allergy, Asthma and Immunology |
| Abstract: | Background: The 52-week, phase 3 LIBERTY ASTHMA QUEST study (NCT02414854) in patients aged above or equal to 12 years with uncontrolled, moderate-to-severe asthma demonstrated the efficacy and safety of dupilumab 200 mg and 300 mg every 2 weeks vs matched placebo. Objective: To assess whether dupilumab improves clinical outcomes in QUEST patients with persistent airflow obstruction (PAO) defined as post-bronchodilator forced expiratory volume in 1 second/forced vital capacity ratio less than 0.7 at baseline. Methods: End points were annualized rate of severe exacerbations, pre and post-bronchodilator forced expiratory volume in 1 second over time, proportion achieving reversal of PAO, and quality of life. Efficacy was evaluated in patients with or without PAO at baseline in subpopulations with eosinophils ���?��� 150 cells/?���L or fractional exhaled nitric oxide (FeNO) ���?��� 25 ppb or eosinophils ���?��� 300 cells/?���L and FeNO ���?��� 25 ppb. Results: Of 1902 patients enrolled in QUEST, 1039 (55%) had PAO at baseline. Dupilumab vs placebo rapidly and significantly improved lung function in patients with PAO and elevated type 2 inflammatory biomarkers at baseline. Dupilumab improved probability of reversing airflow obstruction (hazard ratio vs placebo 1.616 [95% confidence interval, 1.272-2.052] and 1.813 [1.291-2.546]; both P < .001) and significantly reduced severe exacerbations by 69% (relative risk, 0.411; 95% confidence interval [0.327-0.516]; P < .0001) and by 75% (0.252 [0.178-0.356]; P < .0001) in patients with PAO with eosinophils ���?��� 150 cells/?���L or FeNO ���?��� 25 ppb and eosinophils ���?��� 300 cells/?���L and FeNO ���?��� 25 ppb, respectively. Similar results were observed in patient subgroups without PAO. Conclusion: In patients with uncontrolled moderate-to-severe asthma, treatment with dupilumab facilitates reversal of PAO status and improves clinical outcomes. |
| URI: | https://swslhd.intersearch.com.au/swslhdjspui/handle/1/601 |
| Digital object identifier: | 10.1016/j.anai.2022.10.018 |
| Appears in Collections: | Camden and Campbelltown Hospitals |
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