Dupilumab Improves Asthma Control, HRQoL Regardless of Comorbid Th2 Inflammatory Disease

Dupilumab effectively improves asthma control in patients with moderate-to-severe uncontrolled asthma regardless of whether they have coexisting chronic rhinosinusitis (CRS) and/or nasal polyposis (NP), according to new real-world data from the global RAPID registry. The findings, presented at the American Thoracic Society's International Conference 2025, showed the monoclonal antibody also significantly reduced CRS symptoms in participants with these comorbidities.¹

The prospective observational study (NCT04287621) followed 205 participants aged 12 years and older who initiated dupilumab treatment according to country-specific prescribing guidelines. Presenting author Andreanne Cote, MD, MSCE, of the Institut Universitaire de Cardiologie et de Pneumologie de Québec and colleagues divided participants into 2 groups: 94 who had ongoing CRS and/or NP and 111 without these comorbidities.

At week 52, both groups demonstrated similar unadjusted annualized rates of severe asthma exacerbations (0.146 vs. 0.129 for patients with and without CRS/NP, respectively).

Among the participants with ongoing CRS and/or NP, dupilumab reduced Sino-Nasal Outcome Test-22 (SNOT-22) scores by a mean of 15.2 points at after 1 month of treatment, 19.8 points at after 6 months, and 17.0 points at month 12, according to the study abstract. The SNOT-22 scale ranges from 0 to 110, with higher scores indicating more severe symptoms.¹

SNOT-22: scores range from 0 to 110, with higher scores indicating more severe symptoms and greater CRS impact. ACQ-6: scores range from 0 to 6, with higher scores indicating more severe symptoms.

Cote et al reported substantial improvements in asthma control in both groups. Among participants with CRS/NP, mean 6-item Asthma Control Questionnaire (ACQ-6) scores decreased by 0.9 points at month 1 and progressively improved to a reduction of 1.3 points at month 12. Participants without CRS/NP showed similar improvements, with ACQ-6 scores reduced by 1.1 points at month 1 and 1.4 points at month 12, authors reported in the abstract.¹

“Asthma frequently coexists with other type 2 inflammatory diseases such as CRS and NP, resulting in poor asthma control and impaired quality of life,” Cote and colleagues wrote.¹ Dupilumab, a fully human monoclonal antibody, works by blocking the shared receptor component for interleukin (IL)-4 and IL-13, which are key drivers of type 2 inflammation underlying both asthma and sinonasal conditions like CRS and NP. There is a significant body of evidence for the efficacy of dupilumab from clinical trials in asthma, the authors point out, but there are fewer studies evaluating its impact in real-world settings.¹

These findings from the RAPID registry, a global resource, provide important evidence relevant to daily clinical practice for dupilumab as a comprehensive approach to therapy for individuals with asthma complicated by type 2 inflammatory comorbidities.

Dupilumab was approved by the FDA in October 2018 for treatment of moderate-to-severe asthma in people aged 12 years and older; in June 2019 for adults with chronic rhinosinusitis with nasal polyposis; in October 2021 for moderate to severe asthma in children aged 6 1o 11 years; and in September 2024 for adolescents with chronic rhinosinusitis with nasal polyposis.2

References
1. Cote A, Mosnaim GS, Lugogo NL, et al. Dupilumab improves health-related quality of life and asthma control in patients with and without coexisting type 2 conditions: results from the RAPID study [abstract]. Am J Respir Crit Care Med 2025;211:A1399. https://doi.org/10.1164/ajrccm.2025.211.Abstracts.A1399
2. Steward J. Dupixent FDA approval history. Drugs.com. Updated April 23, 2025. Accessed May 21, 2025. https://www.drugs.com/history/dupixent.html