Treatment Shows Early Effectiveness in Real-World Patients With Severe Asthma

Patients with severe type 2 asthma in a real-life setting demonstrated early improvement with dupilumab treatment, according to a study published in Multidisciplinary Respiratory Medicine.

“With our findings, we show that dupilumab, in severe uncontrolled asthmatic patients of type 2 endotype, has clinical efficacy as soon as after 3 months of treatment, improving symptoms, lung function and FeNO [fractional exhaled nitric oxide],” wrote a research team from Italy.

The dual-center, real-life study included 12 patients with severe, uncontrolled asthma treated with dupilumab. During the previous year, all patients had blood eosinophils above 150 cells/ml and/or FeNO above 25 parts per billion (ppb).

Patients showed improvement in asthmatic symptoms, lung function, and FeNO after 3 months of dupilumab treatment, researchers reported. Asthma Control Test (ACT) scores significantly increased from an average 13.25±4.65 at baseline to 19.17±4.45, and FEV₁ percentages from an average 62.58±15.73 to 71.00±13.11. Median FeNO level decreased from 32 ppb to 19 ppb.

Although median blood eosinophil counts increased from 280 to 349.5, the increase did not reach statistical significance, researchers reported, and had no clinical impact.

In all, eight patients achieved minimal clinically important difference (MCID) for ACT, and four achieved MCID for FEV₁, after 3 months of dupilumab.

“It is interesting to underline that the number of patients with a positive MCID for ACT is higher than the percentage of patients with a positive MCID for FEV₁,” researchers wrote. “This may indicate that, like in other biologic drugs for severe asthma, dupilumab’s main early effect is asthma stabilization, also suggested by FeNO reduction.”

Reference:
Carpagnano GE, Scioscia G, Buonamico E, et al. Early effectiveness of type-2 severe asthma treatment with dupilumab in a real-life setting; a FeNO-driven choice that leads to winning management. Multidiscip Respir Med. 2022;17(1):797. doi:10.4081/mrm.2022.797