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

Nowsheen, Somaira; Darveaux, Jared I.

doi:10.1016/j.anai.2021.04.011

Cited by 17 publications

(13 citation statements)

References 6 publications

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“…Unlike other therapeutic antibodies, the RCTs included patients with moderate disease, making dupilumab available for patients with moderate asthma. Real-world data supported the results of the RCTs, showing that dupilumab reduced asthma exacerbations, the daily dose of OCS, and FeNO levels, and improved asthma symptoms [ 73 , 74 ].…”

Section: Clinical Effects Of Antibodies For Bronchial Asthma Patientsmentioning

confidence: 74%

Advances and Challenges of Antibody Therapeutics for Severe Bronchial Asthma

Abe

Suga

Fukushima

et al. 2021

IJMS

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Asthma is a disease that consists of three main components: airway inflammation, airway hyperresponsiveness, and airway remodeling. Persistent airway inflammation leads to the destruction and degeneration of normal airway tissues, resulting in thickening of the airway wall, decreased reversibility, and increased airway hyperresponsiveness. The progression of irreversible airway narrowing and the associated increase in airway hyperresponsiveness are major factors in severe asthma. This has led to the identification of effective pharmacological targets and the recognition of several biomarkers that enable a more personalized approach to asthma. However, the efficacies of current antibody therapeutics and biomarkers are still unsatisfactory in clinical practice. The establishment of an ideal phenotype classification that will predict the response of antibody treatment is urgently needed. Here, we review recent advancements in antibody therapeutics and novel findings related to the disease process for severe asthma.

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Section: Clinical Effects Of Antibodies For Bronchial Asthma Patientsmentioning

confidence: 74%

Advances and Challenges of Antibody Therapeutics for Severe Bronchial Asthma

Abe

Suga

Fukushima

et al. 2021

IJMS

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“…Over long term therapy, this drug also reduces IgE production, 208 which may partly explain ongoing clinical efficacy with treatment cessation after long term use. 209 Real-world studies have shown that the typical patients receiving Omalizumab are younger in age, have earlyonset asthma, and had a higher reported history of co- OCS requirements [264][265][266][267][268] morbid atopic conditions such as allergic rhinitis. 20,26 The multidimensional clinical efficacy of Omalizumab in such patients has been shown in meta-analyses of clinical trials.…”

Section: Omalizumabmentioning

confidence: 99%

“…265 Other reports similarly provide evidence for the aforementioned multidimensional real-world efficacy of Dupilumab. [266][267][268] Even more crucially, in a real-life setting, this drug was efficacious in those who had failed treatment with other asthma biologics. 265,267,268 Indeed, in a recent retrospective study, patients who had an insufficient response to anti-IL-5/IL-5R or anti-IgE biologics, who were then switched to Dupilumab, showed improvements in asthma control, exacerbations and OCS requirements.…”

Section: Dupilumabmentioning

confidence: 99%

“…[266][267][268] Even more crucially, in a real-life setting, this drug was efficacious in those who had failed treatment with other asthma biologics. 265,267,268 Indeed, in a recent retrospective study, patients who had an insufficient response to anti-IL-5/IL-5R or anti-IgE biologics, who were then switched to Dupilumab, showed improvements in asthma control, exacerbations and OCS requirements. 269 This again suggests that inadequate response to a specific biologic should not be accepted as implying poor response to other biologics.…”

Section: Dupilumabmentioning

confidence: 99%

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Recent Insights into the Management of Inflammation in Asthma

Rupani¹,

Fong²,

Kyyaly³

et al. 2021

JIR

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The present prevailing inflammatory paradigm in asthma is of T2-high inflammation orchestrated by key inflammatory cells like Type 2 helper lymphocytes, innate lymphoid cells group 2 and associated cytokines. Eosinophils are key components of this T2 inflammatory pathway and have become key therapeutic targets. Real-world evidence on the predominant T2-high nature of severe asthma is emerging. Various inflammatory biomarkers have been adopted in clinical practice to aid asthma characterization including airway measures such as bronchoscopic biopsy and lavage, induced sputum analysis, and fractional exhaled nitric oxide. Blood measures like eosinophil counts have also gained widespread usage and multicomponent algorithms combining different parameters are now appearing. There is also growing interest in potential future biomarkers including exhaled volatile organic compounds, micro RNAs and urinary biomarkers. Additionally, there is a growing realisation that asthma is a heterogeneous state with numerous phenotypes and associated treatable traits. These may show particular inflammatory patterns and merit-specific management approaches that could improve asthma patient outcomes. Inhaled corticosteroids (ICS) remain the mainstay of asthma management but their use earlier in the course of disease is being advocated. Recent evidence suggests potential roles for ICS in combination with long-acting beta-agonists (LABA) for as needed use in mild asthma whilst maintenance and reliever therapy regimes have gained widespread acceptance. Other anti-inflammatory strategies including ultra-fine particle ICS, leukotriene receptor antagonists and macrolide antibiotics may show efficacy in particular phenotypes too. Monoclonal antibody biologic therapies have recently entered clinical practice with significant impacts on asthma outcomes. Understanding of the efficacy and use of those agents is becoming clearer with a growing body of real-world evidence as is their potential applicability to other treatable comorbid traits. In conclusion, the evolving understanding of T2 driven inflammation alongside a treatable traits disease model is enhancing therapeutic approaches to address inflammation in asthma.

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“…Die Wirksamkeit von Dupilumab war in Real-Life-Studien vergleichbar mit derjenigen aus kontrollierten klinischen Studien 186 195 . Hier konnte auch gezeigt werden 196 197 198 , dass dieses Medikament bei schwerem Asthma auch dann wirksam war, wenn eine Therapie mit anderen Asthma-Biologika versagt hatte 195 197 198 . In einer retrospektiven Studie zeigten Patienten Verbesserungen bei der Asthmakontrolle, den Exazerbationen und dem OCS-Bedarf, die zuvor unzureichend auf Anti-IL-5/IL-5R- oder Anti-IgE-Biologika ansprachen 199 .…”

Section: Biologika Bei Crs Und Asthma In Der Praxisunclassified