Efficacy of dupilumab on clinical outcomes in patients with asthma and perennial allergic rhinitis
| Autor: | Megan S. Rice, Constance H. Katelaris, J. Mark FitzGerald, Siddhesh Kamat, Jorge Maspero, Sivan Harel, Alexandre Jagerschmidt, Asif Khan, Ariel Teper, Neil M.H. Graham, Santiago Quirce, Marcella Ruddy, Bradley E. Chipps, Paul Rowe, Linda B. Ford, Nicola A. Hanania, Gianluca Pirozzi, Yufang Lu, Jonathan Corren, William W. Busse, Nikhil Amin |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male medicine.medical_specialty Rhinitis Allergic Perennial Exacerbation PERSISTENT ASTHMA IMPACT Immunology Immunoglobulin E Placebo medicine.disease_cause Antibodies Monoclonal Humanized 03 medical and health sciences 0302 clinical medicine Double-Blind Method Internal medicine Forced Expiratory Volume Anti-Allergic Agents medicine Medicine and Health Sciences MANAGEMENT Immunology and Allergy Humans 030212 general & internal medicine Receptors Interleukin-4 Type II Asthma HUMANIZATION biology PLACEBO business.industry IL-4 Aeroallergen Middle Aged medicine.disease Dupilumab respiratory tract diseases Eosinophils 030228 respiratory system Asthma Control Questionnaire Exhaled nitric oxide biology.protein Quality of Life Female business Biomarkers |
| Zdroj: | ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY |
| ISSN: | 1081-1206 1534-4436 |
| Popis: | Background: Comorbid perennial allergic rhinitis (PAR) or year-round aeroallergen sensitivity substantially contributes to disease burden in patients with asthma. Dupilumab blocks the shared receptor for interleukin (IL) 4 and IL-13, key drivers of type 2 inflammation that play important roles in asthma and PAR. In the LIBERTY ASTHMA QUEST trial (NCT02414854), dupilumab reduced severe asthma exacerbations and improved forced expiratory volume in 1 second (FEV1) in patients with uncontrolled, moderate-to-severe asthma, with greater efficacy observed in patients with elevated type 2 inflammatory biomarkers at baseline (blood eosinophils and fractional exhaled nitric oxide). Objective: To assess dupilumab efficacy in LIBERTY ASTHMA QUEST patients with comorbid PAR. Methods: Severe asthma exacerbation rates, FEV1, asthma control (5-item Asthma Control Questionnaire), rhinoconjunctivitis-specific health-related quality of life (Standardized Rhinoconjunctivitis Quality of Life Questionnaire +12 scores), and type 2 inflammatory biomarkers during the 52-week treatment period were assessed. Results: A total of 814 of the 1902 patients (42.8%) had comorbid PAR (defined as an allergic rhinitis history and >= 1 perennial aeroallergen specific immunoglobulin E (IgE) level >= 0.35 kU/L at baseline). Dupilumab, 200 and 300 mg every 2 weeks, vs placebo reduced severe exacerbations rates by 32.2% and 34.6% (P = 300 cells/mL) and fractional exhaled nitric oxide. Dupilumab treatment also numerically improved the 5-item Asthma Control Questionnaire and Standardized Rhinoconjunctivitis Quality of Life Questionnaire +12 scores and suppressed type 2 inflammatory biomarkers. Conclusion: Dupilumab improved key asthma-related outcomes, asthma control, and rhinoconjunctivitisspecific health-related quality of life while suppressing type 2 inflammatory biomarkers and perennial allergen-specific IgE in patients with moderate-to-severe asthma and comorbid PAR, highlighting its dual inhibitory effects on IL-4 and IL-13 and its role in managing asthma and PAR. (C) 2020 American College of Allergy, Asthma & Immunology. |
| Databáze: | OpenAIRE |
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