Dupilumab improves clinical outcomes in patients with severe asthma compared to other biologics

 

European patients (Netherlands, Germany, France, Italy, Spain) ≥12 years of age with severe asthma and medical records extending 12 months before and after biologic initiation (24-month study period).

^*Differences in baseline covariates were balanced with inverse probability of treatment weighting (IPTW) between dupilumab and other biologics.  After IPTW, the differences were balanced (standardized difference <10%) for majority of the baseline covariates between dupilumab and other biologics.^†Exacerbation defined as: (i) use of SCS for ≥3 and ≤14 days; or (ii) hospitalization or emergency department visit with asthma as a primary diagnosis; or (iii) asthma exacerbation recorded in the patient record. ^‡OCS prescriptions defined as: rate of OCS prescriptions.  bEOS, blood eosinophils; FeNO, fractional exhaled nitric oxide; FEV₁, forced expiratory volume in 1 second; IgE, immunoglobulin E; OCS, oral corticosteroids; SCS, systemic corticosteroids.

Dupilumab was associated with reduction in asthma exacerbation and OCS prescription and increase lung function compared to omalizumab, benralizumab, and mepolizumab increasing partial remission.

• Symptom data is not available to define clinical remission
• Inverse probability treatment weighting was used to reduce confounding factors between groups; however, some confounding factors may still exist
• Tezepelumab is not included because it was not approved during the timeframe of the study, but future comparisons are warranted

^*Exacerbation defined as: (i) use of SCS for ≥3 and ≤14 days; or (ii) hospitalization or emergency department visit with asthma as a primary diagnosis; or (iii) asthma exacerbation recorded in the patient record. ^†OCS prescriptions defined as: rate of OCS prescriptions. ^‡This analysis includes pathients who had ≥1 FEV₁ measurement in both pre- and post-index periods. ^§A <5% decrease in pre/post-BD FEV₁ from baseline.  
BD, bronchodilator; FEV₁, forced expiratory volume in 1 second; OCS, oral corticosteroids; ppFEV₁, percent predicted FEV₁; SA, severe asthma; SCS, systemic corticosteroids.