Dupilumab Improves Asthma and Sinonasal Outcomes in Adults with Moderate to Severe Atopic Dermatitis

Mark Boguniewicz*, Lisa A. Beck, Lawrence Sher, Emma Guttman-Yassky, Diamant Thaçi, Andrew Blauvelt, Margitta Worm, Jonathan Corren, Weily Soong, Peter Lio, Ana B. Rossi, Yufang Lu, Jingdong Chao, Laurent Eckert, Abhijit Gadkari, Thomas Hultsch, Marcella Ruddy, Leda P. Mannent, Neil M.H. Graham, Gianluca PirozziZhen Chen, Marius Ardeleanu

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: Dupilumab has demonstrated efficacy with acceptable safety in clinical trials in patients with moderate to severe atopic dermatitis (AD). Objective: To assess dupilumab's impact on asthma and sinonasal conditions in adult patients with moderate to severe AD in four randomized, double-blinded, placebo-controlled trials. Methods: In LIBERTY AD SOLO 1 (NCT02277743), SOLO 2 (NCT02755649), CHRONOS (NCT02260986), and CAFÉ (NCT02755649), patients received placebo, dupilumab 300 mg every 2 weeks (q2w), or dupilumab 300 mg weekly (qw). In CHRONOS and CAFÉ, patients received concomitant topical corticosteroids. This post hoc analysis assessed Asthma Control Questionnaire-5 (ACQ-5) scores in patients with asthma, Sino-Nasal Outcome Test-22 (SNOT-22) scores in patients with sinonasal conditions, and AD signs and symptoms in all patients. Results: Of the 2444 patients, 463 had asthma with baseline ACQ-5 ≥ 0.5 (19%); 1171 had sinonasal conditions (48%); and 311 had both (13%). At week 16, ACQ-5 scores (least squares mean change from baseline [standard error]) improved by 0.27 (0.07), 0.59 (0.08), and 0.56 (0.07) in placebo-, q2w-, and qw-treated patients with asthma, respectively, whereas SNOT-22 scores improved by 5.1 (0.8), 9.9 (0.9), and 10.8 (0.8) in patients with sinonasal conditions (P < .01 for all dupilumab vs placebo). Improvements in ACQ-5 and SNOT-22 were also seen in patients with both conditions. Dupilumab also significantly improved AD signs and symptoms among all subgroups. Conclusions: In this first analysis of patients with comorbid moderate to severe AD, asthma, and/or chronic sinonasal conditions, dupilumab improved all three diseases in a clinically meaningful and statistically significant manner (vs placebo), based on validated outcome measures.

Original languageEnglish (US)
Pages (from-to)1212-1223.e6
JournalJournal of Allergy and Clinical Immunology: In Practice
Volume9
Issue number3
DOIs
StatePublished - Mar 2021

Keywords

  • ACQ-5
  • Allergic rhinitis
  • Asthma
  • Atopic dermatitis
  • Dupilumab
  • Eczema
  • Rhinosinusitis
  • SNOT-22
  • Type 2 inflammation
  • Type 2 inflammatory diseases

ASJC Scopus subject areas

  • Immunology and Allergy

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