Effect Of Dupilumab On Severe Exacerbations And Lung Function In Patients With Baseline Blood Eosinophils=500 Cells/Mu L

Background: Uncontrolled, moderate-to-severe asthma in patients (pts) with baseline (BL) blood eosinophils (Eos) ≥500 cells/µL can be difficult to treat. Dupilumab (DPL), a fully human monoclonal antibody, blocks the shared receptor component of IL-4/IL-13, key and central drivers of type 2 inflammation. In phase 3 LIBERTY ASTHMA QUEST (NCT02414854), add-on DPL 200/300mg every 2 weeks (q2w) vs placebo (PBO) reduced severe exacerbations, improved pre-bronchodilator (BD) forced expiratory volume in 1 second (FEV1) in pts with uncontrolled, moderate-to-severe asthma, with greater effects in pts with elevated type 2 biomarkers. Aim: To assess DPL efficacy in QUEST pts with BL blood Eos ≥500 cells/µL. Methods: Annualized severe exacerbation rates in the 52-week treatment period were analyzed using a negative binomial model. Least squares (LS) mean change from BL in pre-BD FEV1 (L) at Week 12 was analyzed using a linear mixed-effect model with repeated measures. Results: DPL 200/300mg q2w vs PBO significantly reduced severe exacerbations by 74.4%/71.3% (both P Table). At Week 12, DPL 200/300mg q2w vs PBO significantly improved pre-BD FEV1 by 0.28L/0.30L in pts with BL Eos ≥500 cells/µL (both P Conclusion: Dupilumab significantly reduced severe exacerbations and improved lung function in patients with BL blood Eos ≥500 cells/µL.