Dupilumab Improves Chances of Clinical Remission in Uncontrolled Asthma - Pulmonology Advisor
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Treatment with the monoclonal antibody dupilumab led to asthma remission by 24 and 52 weeks in a substantial proportion of patients with uncontrolled disease and also reduced exacerbations and improved lung function and asthma control in patients who did not experience remission. These were among the results of a post hoc analysis of the phase 3 Liberty Asthma QUEST trial (ClinicalTrials.gov Identifier: NCT02414854) presented at the American College of Allergy, Asthma, and Immunology (ACAAI) Annual Scientific Meeting, held in New Orleans from November 4 to 8, 2021.
The study included 348 patients with uncontrolled moderate-to-severe asthma who were treated with dupilumab and 195 matched patients treated with placebo. Researchers compared the 2 groups based on a composite endpoint for clinical asthma remission (no exacerbations; Asthma Control Questionnaire (ACQ-5) total score <1.5; and post-bronchodilator forced expiratory volume in 1 second ≥80%) at weeks 24 and 52.
At week 24, a greater proportion of patients treated with dupilumab were free of exacerbations than patients treated with placebo (83.3% vs 61.0%, respectively). More patients treated with dupilumab were also free of exacerbations by week 52 (72.7% vs 46.2%). Additionally, treatment with dupilumab was associated with more patients who were exacerbation free with an ACQ-5 score of less than 1.5 at week 24 (57.5% vs 27.2%) and week 52 (43.1% vs 21.5%).
Approximately 29.6% of patients in the dupilumab group and 7.7% of patients in the placebo group met all investigator-defined criteria for clinical remission at 24 weeks. Additionally, 20.1% and 4.6% of patients in the dupilumab and placebo arms, respectively, met these criteria at 52 weeks.
In a subgroup of patients who did not experience remission at the 24- and 52-week follow-up periods, more patients treated with dupilumab vs placebo had fewer exacerbations (adjusted annualized severe exacerbation rate [weeks 24/52], 0.73/0.62 vs 1.14/1.04) and greater lung function and improvements in asthma control.
Among patients who experienced remission at week 24, there were significantly better improvements in lung function and asthma control outcomes with dupilumab at week 52 than in patients who did not experience remission (P <.001 for both).
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Reference
Pavord I, Busse W, Israel E, et al. Dupilumab leads to clinical asthma remission indicative of comprehensive improvement in patients with asthma. Presented at: American College of Allergy, Asthma & Immunology (ACAAI) Annual Scientific Meeting; November 4-8, 2021; New Orleans, LA. Abstract P067.
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