From the Guidelines
Dupixent (dupilumab) significantly improves asthma outcomes, including lung function and control, in patients with severe chronic rhinosinusitis with nasal polyps (CRSwNP), as demonstrated in the Liberty NP SINUS-24 and Liberty NP SINUS-52 studies 1. The medication has been shown to improve FEV1 and asthma control in these patients, suggesting its potential benefits in managing asthma symptoms.
- Key benefits of Dupixent for asthma patients include:
- Improved lung function, as measured by FEV1
- Enhanced asthma control
- Potential reduction in asthma exacerbations
- The recommended dosage of Dupixent for asthma patients is 300mg every two weeks, although the initial loading dose and maintenance regimen may vary depending on the specific patient population and clinical context.
- It is essential to note that Dupixent is not a rescue medication and should be used in conjunction with other asthma treatments, such as rescue inhalers, as prescribed by a healthcare provider.
- While the studies primarily focused on patients with CRSwNP, the findings suggest that Dupixent may be beneficial for asthma patients with similar inflammatory profiles, such as those with eosinophilic or allergic asthma 1.
From the FDA Drug Label
Figure 6: Kaplan Meier Incidence Curve for Time to First Severe Exacerbation in Subjects with Moderate-to-Severe Asthma with Baseline Blood Eosinophils ≥300 cells/mcL (QUEST) The mean treatment difference versus placebo was 0.14 L (95% CI: 0.08,0.19) and 0.13 L (95% CI: 0.08,0. 18) for DUPIXENT 200 mg Q2W and 300 mg Q2W, respectively. Table 20: Mean Change from Baseline and Difference vs Placebo in Pre-Bronchodilator FEV1 at Week 12 in Subjects with Moderate-to-Severe Asthma (DRI12544 and QUEST) The ACQ-5 responder rate for DUPIXENT 200 mg and 300 mg Q2W in the overall population was 69% vs 62% placebo (odds ratio 1.37; 95% CI: 1.01,1.86) and 69% vs 63% placebo (odds ratio 1.28; 95% CI: 0.94,1.73), respectively
Effect of Dupixent on Asthma:
- Lung Function: Dupixent (dupilumab) significantly improved pre-bronchodilator FEV1 in subjects with moderate-to-severe asthma, with a mean treatment difference versus placebo of 0.14 L (95% CI: 0.08,0.19) and 0.13 L (95% CI: 0.08,0.18) for 200 mg Q2W and 300 mg Q2W, respectively 2.
- Asthma Exacerbations: Dupixent reduced the annualized rate of severe asthma exacerbation events, with a rate ratio of 0.41 (95% CI: 0.26,0.63) compared to placebo 2.
- Symptom Control: Dupixent improved symptom control, with ACQ-5 responder rates of 69% vs 62% placebo (odds ratio 1.37; 95% CI: 1.01,1.86) and 69% vs 63% placebo (odds ratio 1.28; 95% CI: 0.94,1.73) for 200 mg Q2W and 300 mg Q2W, respectively 2.
From the Research
Effect of Dupixent (Dupilumab) on Asthma
- Dupilumab has been shown to increase lung function and reduce severe exacerbations in patients with uncontrolled persistent asthma, irrespective of baseline eosinophil count 3.
- The treatment has been found to be effective in reducing annualized rates of exacerbation in the overall population, as well as in subgroups with at least 300 eosinophils per μL and fewer than 300 eosinophils per μL 3.
- In patients with persistent, moderate-to-severe asthma and elevated eosinophil levels, dupilumab therapy has been associated with fewer asthma exacerbations when LABAs and inhaled glucocorticoids are withdrawn, with improved lung function and reduced levels of Th2-associated inflammatory markers 4.
Dupilumab in Specific Populations
- Dupilumab has been found to be effective in patients with severe allergic asthma non-responsive to omalizumab, with significant reductions in exacerbation number and OCS use 5.
- The treatment has also been shown to be effective in patients with glucocorticoid-dependent asthma, reducing the use of corticosteroids and improving lung function 6.
- In patients with type 2-high asthma receiving high-dose inhaled corticosteroids at baseline, dupilumab has been found to significantly reduce severe exacerbations and improve lung function and asthma control 7.
Safety Profile
- The most common adverse events associated with dupilumab are upper respiratory tract infections and injection-site reactions 3.
- Other adverse events reported with dupilumab include nasopharyngitis, nausea, and headache 4.
- Dupilumab has been found to be generally well-tolerated in patients with uncontrolled, persistent or moderate-to-severe asthma 7.