Dupilumab Reduces Oral Corticosteroid Use in Patients with Severe Asthma

Cropped shot of a young woman blowing her nose with a tissue at home

A post-hoc analysis of the phase III LIBERTY ASTHMA VENTURE study comparing patients with and without self-reported comorbid allergic rhinitis (AR) was published as part of the AAAAI Annual Meeting.

In the trial, patients with oral corticosteroid (OCS)-dependent asthma were assigned either dupilumab 300 mg every two weeks or placebo. Dupilumab patients reduced OCS use and severe asthma exacerbations, as well as improved pre-bronchodilator forced expiratory volume in 1 second (FEV1). The present study assessed dupilumab’s efficacy by self-reported AR status. Researchers assessed percentage reduction in OCS dose and change in pre-bronchodilator FEV1 from baseline to week 24 and annualized rate of severe asthma exacerbations over 24 weeks in 210 patients who were stratified by whether they did (n=117) or did not (n=93) have comorbid AR.

After 24 weeks, patients with and without AR taking dupilumab versus placebo reduced their OCS dose (least squares [LS] mean difference, 32.78% [P<0.0001] vs. 24.44% [P=0.02], respectively) and improved FEV1 (LS mean difference, 0.23L [P=0.01] vs. 0.24L [P=0.008], respectively). Patients taking dupilumab had reduced annualized severe asthma exacerbation rates over 24 weeks in both the AR (65.5%; P=0.0004) and non-AR groups (51.1%; P=0.04). Transient eosinophilia presented in 14% of dupilumab-treated patients and 1% of placebo-treated patients, with no reported clinical consequences or associated adverse events.

“Dupilumab reduced OCS use while reducing severe asthma exacerbation rate and improving FEV1 in patients with OCS-dependent, severe asthma with and without AR,” the researchers concluded.

https://www.jacionline.org/article/S0091-6749(19)32063-9/fulltext