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Open Access Green möglich sobald Postprint bei der ZB eingereicht worden ist.
Dupilumab improves asthma control and lung function in patients with insufficient outcome during previous antibody therapy.
J. Allergy Clin. Immunol. Pract. 9, 1177-1185.e4 (2020)
Background: Biological treatments directed against IgE and IL-5 have largely improved outcomes for patients with severe type 2–high asthma. However, a fraction of patients with severe asthma show insufficient treatment outcome under anti-IgE and anti–IL-5/IL-5 receptor α antibodies. Objective: To evaluate whether switching to dupilumab was of benefit in patients with insufficient outcome under previous anti-IgE or anti–IL-5/IL-5 receptor α therapy. Methods: We retrospectively analyzed 38 patients who were switched to dupilumab from a previous anti-IgE or anti–IL-5/IL-5 receptor α medication because of insufficient outcome. We defined response criteria after 3 to 6 months as an improvement in at least 1 of the following criteria without deterioration in the other criteria, comparing values under dupilumab with values under previous antibody therapy: (1) increase of 3 or more in Asthma Control Test score, (2) 50% or more reduction in oral corticosteroid dose, and (3) FEV1 improvement greater than or equal to 150 mL, and classified patients as responders and nonresponders. Results: Switch to dupilumab led to a response in 76% of patients. In the total cohort, Asthma Control Test score increased by a mean of 2.9 (P < .0001), whereas exacerbations decreased significantly (P < .0001) and number of oral corticosteroid–dependent patients decreased from 15 to 12. Mean FEV1 improved by 305 mL (P < .0001). Median fractional exhaled nitric oxide decreased by −30 ppb (P < .0001), whereas eosinophil counts increased by 0.17 G/L (P < .01). There were no significant differences in clinical characteristics between responders and nonresponders to dupilumab. However, patients with increased fractional exhaled nitric oxide (≥25 ppb) during previous antibody therapy were more often responders than patients with low fractional exhaled nitric oxide (<25 ppb) (P < .05). Conclusions: Altogether, we show that a switch to dupilumab in patients with insufficient outcome under previous biological therapy was effective in most patients.
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Publikationstyp
Artikel: Journalartikel
Dokumenttyp
Wissenschaftlicher Artikel
Schlagwörter
Dupilumab ; Ige ; Il-13 ; Il-4 ; Il-5 ; Severe Asthma ; Type 2 Inflammation
ISSN (print) / ISBN
2213-2198
e-ISSN
2213-2201
Quellenangaben
Band: 9,
Heft: 3,
Seiten: 1177-1185.e4
Verlag
Elsevier
Verlagsort
Amsterdam [u.a.]
Nichtpatentliteratur
Publikationen
Begutachtungsstatus
Peer reviewed
Institut(e)
Lung Health and Immunity (LHI)