Dupilumab improves long‐term outcomes in patients with uncontrolled, moderate‐to‐severe GINA‐based type 2 asthma, irrespective of allergic status

Abstract

AbstractBackgroundPrevious research has shown greater efficacy of dupilumab in patients with uncontrolled asthma and type 2 inflammation. We analyzed dupilumab's efficacy in patients from the TRAVERSE study with or without evidence of allergic asthma and type 2 inflammation per current GINA guidelines (≥150  eosinophils/μL or FeNO ≥20 ppb).MethodsAll patients aged ≥12 years who rolled over from the placebo‐controlled QUEST study (NCT02414854) to TRAVERSE (NCT02134028) received add‐on dupilumab 300 mg every 2 weeks for up to 96 weeks. We assessed annualized severe asthma exacerbation rates (AERs) and changes from parent‐study baseline (PSBL) in pre‐bronchodilator FEV1 and 5‐item asthma control questionnaire (ACQ‐5) score in patients with moderate‐to‐severe type 2 asthma with and without evidence of allergic asthma at PSBL.ResultsIn TRAVERSE, dupilumab consistently reduced AER across all subgroups. By Week 96, dupilumab increased pre‐bronchodilator FEV1 from PSBL by 0.35–0.41 L in patients receiving placebo during QUEST (placebo/dupilumab) and 0.34–0.44 L in those receiving dupilumab during QUEST (dupilumab/dupilumab) with an allergic phenotype at baseline. In patients without evidence of allergic asthma, pre‐bronchodilator FEV1 improved by 0.38–0.41 L and 0.33–0.37 L, respectively. By Week 48, ACQ‐5 scores decreased from PSBL by 1.63–1.69 (placebo/dupilumab) and 1.74–1.81 (dupilumab/dupilumab) points across subgroups with allergic asthma, and 1.75–1.83 (placebo/dupilumab) and 1.78–1.86 (dupilumab/dupilumab) in those without.ConclusionsLong‐term treatment with dupilumab reduced exacerbation rates and improved lung function and asthma control in patients with asthma with type 2 inflammation as per current GINA guidance and irrespective of evidence of allergic asthma.