Therapy Improves Asthma in Patients With Chronic Rhinosinusitis and Nasal Polyps

Long-term dupilumab demonstrated efficacy in patients with asthma with coexisting chronic rhinosinusitis and/or nasal polyps (CRS/NP), according to study results published in the Annals of Allergy, Asthma, & Immunology.

“Although this post hoc analysis of TRAVERSE evaluated patients with asthma and self-reported coexisting CRS/NP, dupilumab is only approved for the treatment of patients with physician-verified inadequately controlled CRS with NP,” researchers wrote. “These exploratory data provide up to 3 years of clinical asthma efficacy data and highlight the key role of the shared type 2 inflammatory process in both diseases and, thus, the potential of simultaneously addressing asthma and CRS/NP.”

The post hoc analysis of the TRAVERSE open-label extension looked at long-term efficacy in patients enrolled from QUEST (uncontrolled, moderate-to-severe asthma) and VENTURE (oral corticosteroid-dependent asthma) with and without self-reported coexisting CRS/NP.

Between parent study baseline to the end of TRAVERSE at week 96, exacerbation rates decreased from 2.39 to 0.32 in QUEST participants and 2.32 to 0.35 in VENTURE participants with coexisting CRS/NP treated with dupilumab/dupilumab. With placebo/dupilumab, rates decreased from 2.36 to 0.41 in QUEST participants and 2.36 to 0.45 in VENTURE participants with coexisting CRS/NP, according to the study. The improvements were similar to those in patients without CRS/NP.

Improvements in pre-bronchodilator forced expiratory volume in one second (FEV₁), Asthma Control Questionnaire – 5 scores, and Asthma Quality of Life Questionnaire scores in the parent studies were maintained in TRAVERSE, the analysis showed. By Week 96, 71% of oral corticosteroid-dependent patients with CRS/NP treated with dupilumab/dupilumab, and 39% of oral corticosteroid-dependent patients with CRS/NP treated with placebo/dupilumab, ceased oral corticosteroids. In patients without CRS/NP, the oral corticosteroid discontinuation rates were 83% with dupilumab/dupilumab and 47% with placebo/dupilumab.

“In summary, in this long-term analysis of patients with moderate-to-severe or oral corticosteroid-dependent asthma with or without self-reported coexisting CRS/NP, safety was consistent with the known dupilumab safety profile and led to a sustained reduction in exacerbations and improvements in lung function, asthma control, and quality of life, as well as oral corticosteroid dose reduction in baseline oral corticosteroid-dependent patients,” researchers wrote. “The findings in these patients indicate a role for dupilumab as an oral corticosteroid-sparing treatment in patients with severe asthma both with and without self-reported coexisting CRS/NP.”

Sanofi and Regeneron Pharmaceuticals Inc. sponsored the research.

Reference:
Berger P, Menzies-Gow A, Peters AT, et al. Long-term efficacy of dupilumab in asthma with and without chronic rhinosinusitis and/or nasal polyps. Ann Allergy Asthma Immunol. Published online November 7, 2022. doi:10.1016/j.anai.2022.11.006