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Dupilumab Reduces Rate of Severe Asthma Exacerbations

WEDNESDAY, May 23, 2018 -- Add-on dupilumab reduces the rate of severe asthma exacerbations in uncontrolled asthma; it also reduces the glucocorticoid dose for glucocorticoid-treated asthma, according to two studies published online May 21 in the New England Journal of Medicine. The research was published to coincide with the American Thoracic Society's 2018 International Conference, held from May 18 to 23 in San Diego.

Mario Castro, M.D., from the Washington University School of Medicine in St Louis, and colleagues randomized 1,902 patients with uncontrolled asthma to receive add-on subcutaneous dupilumab at a dose of 200 or 300 mg every two weeks or matched volume placebos for 52 weeks. The researchers found that the annualized rate of severe asthma exacerbations was 47.7 percent lower with dupilumab 200 mg than placebo; similar results were seen for the 300 mg dupilumab dose. The forced expiratory volume in one second (FEV1) had increased by 0.32 liters in patients assigned to dupilumab 200 mg at week 12; results were similar with 300 mg dupilumab.

Klaus F. Rabe, M.D., Ph.D., from LungenClinic Grosshansdorf in Germany, and colleagues randomized 210 patients with oral glucocorticoid-treated severe asthma to receive add-on dupilumab (300 mg) or placebo for 24 weeks. Glucocorticoid doses were adjusted in a downward trend from week four to 20 and were maintained at a stable dose for four weeks. The researchers found that the percentage change in the glucocorticoid dose was −70.1 and −41.9 percent in the dupilumab and placebo groups, respectively, at week 24.

"In patients with glucocorticoid-dependent severe asthma, dupilumab treatment reduced oral glucocorticoid use while decreasing the rate of severe exacerbations and increasing the FEV1," Rabe and colleagues write.

Both studies were funded by Sanofi and Regeneron Pharmaceuticals, the manufacturers of dupilumab.

Abstract/Full Text - Castro
Abstract/Full Text - Rabe
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Posted: May 2018