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Dupilumab significantly reduced severe asthma exacerbations and improved prebronchodilator forced expiratory volume in 1 second (FEV1) in patients with baseline fractional exhaled nitric oxide (FeNO) greater than or equal to 25 ppb with/without substantial FeNO reduction, according to a post hoc analysis presented at the American College of Allergy, Asthma & Immunology (ACAAI) Annual Scientific Meeting, held virtually from November 13 to 15.
In the phase 3 LIBERTY ASTHMA QUEST study (ClinicalTrials.gov Identifier: NCT02414854), add-on dupilumab 200 mg and 300 mg every 2 weeks vs placebo significantly reduced severe exacerbations, improved prebronchodilator FEV1, and was generally well tolerated in patients with uncontrolled, moderate to severe asthma. Rapid FeNO reduction has been shown to predict treatment response in patients with asthma; therefore, researchers conducted a post hoc analysis of LIBERTY ASTHMA QUEST to assess dupilumab efficacy in patients with baseline FeNO greater than or equal to 25 ppb with/without substantial FeNO reduction.
Substantial reduction in FeNO was defined as a 20% or more reduction in patients with FeNO greater than or equal to 50 ppb at baseline, or a more than 10 ppb reduction in patients with FeNO less than 50 ppb at baseline.
Significantly more patients treated with dupilumab (70.2%) than patients given placebo (38.9%) achieved substantial FeNO reduction (odds ratio, 4.19; 95% CI, 3.11-5.64; P <.0001). The percentage decrease in FeNO from baseline was overall higher in patients treated with dupilumab vs placebo with/without substantial FeNO reduction. In addition, dupilumab significantly reduced severe exacerbations vs placebo, and improved prebronchodilator FEV1 (least squares mean difference 0.20 [95% CI, 0.12-0.28]/0.17 [95% CI, 0.09-0.26]) in patients with/without substantial FeNO reduction (P <.001 for all).
“Dupilumab vs placebo significantly reduced severe exacerbations and improved prebronchodilator FEV1 in patients with baseline FeNO ≥ 25 ppb with/without substantial FeNO reduction,” the researchers concluded.
Disclosure: This clinical trial was supported by Sanofi. Please see the original reference for a full list of authors’ disclosures.
Halpin D, Korn S, Matucci A, et al. Efficacy of dupilumab in patients with asthma with/without substantial reduction in fractional exhaled nitric oxide. Presented at: the American College of Allergy, Asthma & Immunology (ACAAI) Annual Scientific Meeting (Virtual Experience); November 13-15, 2020. Abstract P221.