What is the proper use and management of Quillipta (dupilumab) for respiratory conditions like asthma or Chronic Obstructive Pulmonary Disease (COPD)?

Quillipta (Dupilumab) - Clarification Required

There appears to be a confusion in terminology: "Quillipta" is not dupilumab. Quillipta is not a recognized medication name in respiratory medicine. If you are asking about dupilumab (Dupixent) for respiratory conditions, the evidence supports its use specifically in certain COPD and asthma populations. If you meant the Ellipta inhaler device, this is a delivery system for various bronchodilators and corticosteroids, not a specific drug.

If You Are Asking About Dupilumab (Dupixent):

COPD Management with Dupilumab

Dupilumab should be reserved for COPD patients with type 2 inflammation (blood eosinophils ≥300 cells/μL) who remain symptomatic with frequent exacerbations despite optimized triple therapy (inhaled corticosteroid + long-acting β2-agonist + long-acting muscarinic antagonist). 1, 2

Patient Selection Criteria:

• Blood eosinophil count ≥300 cells/μL during screening 1, 2
• Age 40-85 years with physician-diagnosed COPD for ≥12 months 1
• Post-bronchodilator FEV1/FVC ratio <0.7 and FEV1 30-70% predicted 1
• History of ≥2 moderate or ≥1 severe exacerbation in the previous year while on triple therapy 1
• Chronic productive cough for ≥3 months in the previous year 1
• Current or former smokers with ≥10 pack-year history 1

Key Exclusions:

• History of asthma (unless considering asthma-COPD overlap syndrome) 1
• Other pulmonary diseases or systemic diseases associated with elevated eosinophils 1

Dosing and Administration:

• 300 mg subcutaneously every 2 weeks as add-on to continued triple therapy 1, 2

Expected Outcomes:

• 30% reduction in moderate or severe exacerbations (rate ratio 0.687) 1
• 83 mL improvement in prebronchodilator FEV1 at 12 weeks, sustained through 52 weeks 2
• 3.4-point improvement in SGRQ score (quality of life) at 52 weeks 2
• 1.1-point improvement in E-RS-COPD symptom score at 52 weeks 2
• Longer time to first severe exacerbation compared to placebo 1

Asthma Management with Dupilumab

For uncontrolled moderate-to-severe asthma, dupilumab may prevent or slow lung function decline and reduce exacerbations, particularly in patients with elevated FeNO (≥35 ppb). 3

• Dupilumab is being studied for its disease-modifying potential in preventing long-term lung function decline in asthma patients 3
• The ATLAS trial is evaluating 3-year outcomes in this population 3

Safety Profile:

• Treatment-emergent adverse events, serious adverse events, discontinuations, and deaths were similar between dupilumab and placebo groups 1
• No unique safety signals identified in COPD populations 1, 2

If You Are Asking About the Ellipta Inhaler Device:

The Ellipta is a dry powder inhaler delivery system used for multiple inhaled medications in single daily-dose regimens, making it suitable for patients struggling with complex therapy regimens 4.

• Medium resistance device with consistent dose delivery across various inspiratory flow rates 4
• Proven easy to use and preferred by patients compared to other inhaler devices 4
• Used to deliver bronchodilators and corticosteroids, not a specific medication itself 4

Standard COPD Management (Without Biologics):

For context, traditional COPD management follows this algorithm based on severity:

Mild COPD (FEV1 ≥70% predicted):

• Short-acting β2-agonist or anticholinergic as needed 5
• Smoking cessation is essential 5

Moderate COPD (FEV1 <70% but ≥60% predicted):

• Regular bronchodilator therapy with β2-agonist and/or anticholinergic 5
• Consider corticosteroid trial 5

Severe COPD (FEV1 <60% predicted):

• Monotherapy with long-acting anticholinergic OR long-acting β2-agonist as first-line 5
• Combination therapy may be considered for persistent symptoms 5
• Theophyllines have limited value and require monitoring (target 5-15 μg/mL) 5, 6

Please clarify which medication or device you are asking about for more specific guidance.