Real-world efficacy and safety of dupilumab use in the treatment of asthma

Abstract

Asthma affects people of all races and ethnic groups worldwide. 1 Fuseini H Newcomb DC Mechanisms driving gender differences in asthma. Curr Allergy Asthma Rep. 2017; 17: 19 Crossref PubMed Scopus (188) Google Scholar Uncontrolled asthma has a major impact on daily life with unscheduled clinic or emergency department visits, hospitalizations, and impact on daily activity. 2 Zeiger RS Schatz M Dalal AA et al. Utilization and costs of severe uncontrolled asthma in a managed-care setting. J Allergy Clin Immunol Pract. 2016; 4 (e3): 120-129 Abstract Full Text Full Text PDF PubMed Scopus (110) Google Scholar Symptoms of asthma including cough, shortness of breath, chest tightness, and wheezing have a substantial impact on the quality of life. Frequent exacerbations can lead to airway remodeling, worsening obstruction, and reduced lung function. Inhaled corticosteroids and β-agonists have been the treatment of choice for years. Although many patients are well-controlled with inhaled treatment options, many have uncontrolled symptoms and ongoing exacerbations. Those with frequent exacerbations are subjected to systemic corticosteroids, which carry a risk of both short- and long-term adverse effects. The recent development of biologic therapies has broadened treatment options, offering hope to those with difficult to control asthma. One of the newest biologic agents, dupilumab, is a human monoclonal antibody that inhibits the signaling of interleukin 4 and interleukin 13. These TH2 cytokines drive inflammation in allergic diseases such as atopic dermatitis, asthma, and nasal polyposis. 3 Simpson EL Akinlade B Ardeleanu M Two phase 3 trials of Dupilumab versus placebo in atopic dermatitis. N Engl J Med. 2017; 376: 1090-1091 Crossref PubMed Scopus (93) Google Scholar Dupilumab is approved for use as an add-on maintenance treatment for people aged 12 years and older who have moderate-to-severe eosinophilic or oral steroid–dependent asthma that is not controlled with their current asthma medicines. 4 Castro M Corren J Pavord ID et al. Dupilumab efficacy and safety in moderate-to-severe uncontrolled asthma. N Engl J Med. 2018; 378: 2486-2496 Crossref PubMed Scopus (863) Google Scholar ,5 Rabe KF Nair P Brusselle G et al. Efficacy and safety of dupilumab in glucocorticoid-dependent severe asthma. N Engl J Med. 2018; 378: 2475-2485 Crossref PubMed Scopus (570) Google Scholar Studies on real-world safety and efficacy of dupilumab on asthma treatment are lacking. Our aims were to determine the effectiveness and adverse effects of dupilumab in people with asthma.