REAL-WORLD EFFECTIVENESS OF DUPILUMAB ON ORAL CORTICOSTEROID USE IN PATIENTS WITH MODERATE-TO-SEVERE ASTHMA

Abstract

<h3>Introduction</h3> Dupilumab, a fully human monoclonal antibody, blocks the shared receptor component for interleukin-4/-13, key and central drivers of type 2 inflammation in asthma. Patients with oral-corticosteroid (OCS)-dependent severe asthma are at increased risk of OCS-related adverse events. In phase 3 VENTURE (NCT02528214), add-on dupilumab 300 mg every 2 weeks vs placebo reduced OCS maintenance dose in patients with OCS-dependent severe asthma. Dupilumab demonstrated an acceptable safety profile. We investigated the real-world effectiveness of dupilumab in reducing OCS use in patients with OCS-dependent severe asthma. <h3>Methods</h3> This retrospective, single-arm study analyzed data from the Avalere Claims database, a large US insurance claims database. Patients diagnosed with moderate-to-severe asthma (GINA 4/5) initiating dupilumab between November 1, 2018, and July 31, 2019, were included. Exclusion criteria were chronic obstructive pulmonary disease (COPD) diagnosis or treatment with another biologic for asthma in the previous year. There were 141 OCS-dependent patients included in this analysis (<b>Table</b>). The proportions of patients with any OCS use, mean annualized cumulative OCS dose, and percentage of patients with ≥90 days of OCS use were assessed pre and post 12 months of dupilumab initiation. <h3>Results</h3> Dupilumab significantly reduced the proportion of patients with any OCS use by 20.6% [<i>P</i>=<0.0001], the mean annualized cumulative OCS dose by 33.4% [<i>P</i>=<0.01], and patients with ≥90 days of OCS-use by 42% [<i>P</i>=<0.0001] in OCS-dependent patients from the 12-month pre baseline to the 12-month follow-up period. <h3>Conclusion</h3> Dupilumab is effective in reducing OCS use in patients with moderate-to-severe OCS-dependent asthma in real-world settings.