The monoclonal antibody dupilumab alleviates asthma symptoms and improves patients’ ability to breathe better than standard therapies, according to a new study.
The results, published May 21, 2018 in the New England Journal of Medicine, show the rate of asthma exacerbations was cut almost in half for those taking dupilumab compared with those taking placebo.
“This drug not only reduced severe symptoms of asthma, it improved the ability to breathe. That’s important because these patients have a chronic disabling disease that worsens over time with loss of lung function,” said Mario Castro, MD, the Alan A. and Edith L. Wolff Professor of Pulmonology and Critical Care Medicine at Washington University School of Medicine in St. Louis, Missouri. “So far, we do not have a drug for asthma that changes the course of the disease. Current drugs for severe asthma help reduce trips to the emergency room, for example, but they don’t improve lung function.”
The 52-week QUEST study included 1902 patients with uncontrolled asthma randomized to receive subcutaneous dupilumab as an add-on therapy at doses of 200 or 300 mg every 2 weeks, or matched-volume placebo injections. Primary endpoints included annualized severe exacerbation rate and absolute change from baseline to week 12 in forced expiratory volume in 1 second (FEV1) before bronchodilator use. Secondary endpoints included exacerbation rate and FEV1 in patients with blood eosinophil counts of ≥300 mm3.
The annualized rate of severe asthma exacerbations was 0.46 among patients assigned to 200 mg of dupilumab every 2 weeks and 0.87 among those assigned to a matched placebo, for a 47.7% lower rate with dupilumab vs placebo. Similar results were seen with the dupilumab dose of 300 mg every 2 weeks.
Castro M, Corren J, Pavord ID, et al. Dupilumab efficacy and safety in moderate-to-severe uncontrolled asthma. N Engl J Med. https://www.nejm.org/doi/10.1056/NEJMoa1804092?url_ver=Z39.88-2003&rfr_i.... Published May 21, 2018. Accessed May 31, 2018.