Dupilumab reduces severe asthma exacerbations regardless of early improvements in lung function
NEW ORLEANS — In a post hoc analysis of the LIBERTY ASTHMA VENTURE study, treatment with dupilumab resulted in reduced severe asthma exacerbations in patients with oral corticosteroid-dependent severe asthma both with and without early improvements in lung function.
“Low FEV1 is a predictor of asthma exacerbation and progressive lung function decline, and is associated with general, pulmonary and cardiovascular mortality,” Nicola A. Hanania, MD, MS, associate professor and director of the Airways Clinical Research Center at Baylor College of Medicine and director of the Asthma and COPD Clinic at Ben Taub Hospital in Houston, said during a presentation at the CHEST Annual Meeting.
The new analysis used data from the LIBERTY ASTHMA QUEST study to evaluate the efficacy of dupilumab 300 mg (Dupixent, Sanofi/Regeneron) on reduction of severe exacerbations in patients with oral corticosteroid-dependent severe asthma who were stratified by clinically meaningful improvements — at least 100 mL or at least 200 mL — in pre-bronchodilator FEV1 at week 12.
In the overall LIBERTY ASTHMA VENTURE study, add-on dupilumab 300 mg every 2 weeks, compared with placebo, yielded significant reductions in oral corticosteroid maintenance dose and improved pre-bronchodilator FEV1, independent of baseline eosinophil levels, in this patient population.
In the new analysis, at week 12, more patients assigned dupilumab, compared with placebo, achieved improvement in pre-bronchodilator FEV1 of at least 100 mL (65.7% vs. 33.3%; P < .0001) and at least 200 mL (49.5% vs. 23.8%; P = .0002), according to the new data.
Treatment with dupilumab reduced severe exacerbations over 24 weeks by 72% (P < .0001) in those with an improvement of at least 100 mL and by 71.9% (P = .0003) in those with an improvement of at least 200 mL, according to the results. Among patients who achieved an improvement in lung function of less than 100 mL, dupilumab reduced severe exacerbations by 45% (P = .08) and in those with an improvement of less than 200 mL by 57% (P = .006).
“In this post hoc analysis, dupilumab reduced severe asthma exacerbations during the 24-week treatment period in oral corticosteroid-dependent severe asthma patients with and without clinically meaningful improvements in lung function at week 12,” Hanania said. – by Katie Kalvaitis
Hanania NA. Getting it right: Personalized strategies for better asthma control. Presented at: CHEST Annual Meeting; Oct. 19-23, 2019; New Orleans.
Disclosures: The study was funded by Sanofi and Regeneron. Hanania reports he has financial relationships with AstraZeneca, Boehringer Ingelheim, Genentech, GlaxoSmithKline, Mylan, Novartis, Regeneron, Sanofi and Sunovion.