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29 Nov 2019
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The European Society of Cardiology (ESC) has released five new guidelines at the ESC Congress 2019, recommending an even lower LDL-C* target in patients at very high risk for cardiovascular disease (CVD), and the use of SGLT2** inhibitors and GLP-1*** receptor agonists as first-line treatments in those with diabetes to reduce their CVD risk.

Roshini Claire Anthony, 16 Dec 2016

Five years of extended therapy with the aromatase inhibitor (AI) letrozole did not improve survival in postmenopausal breast cancer patients, according to findings of the NRG Oncology/NSABP B-42 trial presented at the San Antonio Breast Cancer Symposium (SABCS 2016) held in Texas, US. 

Jackey Suen, 21 Dec 2016

Adding everolimus to fulvestrant in second-line treatment of hormone receptor (HR)-positive, HER2-negative advanced breast cancer improves progression-free survival (PFS) by 40 percent, the phase II PrECOG 0102 study has shown. [SABCS 2016, abstract S1-02]

Dupilumab improves late-onset asthma outcomes

Elaine Soliven
07 Jun 2019
Dr Nicola Hanania

Treatment with dupilumab, a fully human monoclonal antibody that inhibits interleukin (IL)-4 and IL-13 signalling, significantly reduces severe exacerbation rate and improves lung function in patients with late-onset asthma, according to results of a post hoc analysis of the Liberty Asthma Quest* trial presented at ATS 2019.

Of the 1,902 patients with uncontrolled, moderate-to-severe asthma who were randomly assigned to receive add-on dupilumab 200 or 300 mg subcutaneously every 2 weeks or a matching placebo for 52 weeks in Liberty Asthma Quest, 533 patients with late-onset asthma were included in the current post hoc analysis. The analysis stratified patients (>40 years of age) based on their baseline post-bronchodilator FEV1/FVC** ratios (<0.7 L; n=308 or ≥0.7 L; n=225). [ATS 2019, abstract A2667/P502]

Among late-onset asthma patients with fixed airway obstruction (baseline post-bronchodilator FEV1/FVC <0.7 L), those who received dupilumabhad a significantly reduced rate of severe exacerbations compared with placebo (relative risk [RR], 0.48 vs 1.53; p<0.001 for 200 mg or 0.33 vs 1.34; p<0.001 for 300 mg).

A lower rate of severe exacerbation was also observed among patients without fixed airway obstruction (baseline post-bronchodilator FEV1/FVC ≥0.7 L) in the dupilumab arm than the placebo arm (0.37 vs 0.82; p<0.05 for 200 mg or 0.37 vs 0.75; p<0.05 for 300 mg).

Dupilumab200 and 300 mg significantly reduced severe exacerbations in uncontrolled, moderate-to-severe asthma patients with age at onset of asthma >40 years, both in the presence or absence of fixed airflow obstruction,” said study author Dr Nicola Hanania from Baylor College of Medicine in Houston, Texas, US.

However, the benefit of dupilumab vs placebo was greater among patients with fixed airway obstruction than those without (reduction in exacerbation rate, 69.0 percent vs 55.0 percent for 200 mg and 76.0 percent vs 51.0 percent for 300 mg).

At 52 weeks, patients with fixed airway obstruction treated with dupilumab vs placebo had improved pre-bronchodilator FEV1(p<0.05 and p=0.09 for 200 and 300 mg, respectively) and post-bronchodilator FEV1ratios (p<0.05 and p=0.06 for 200 and 300 mg, respectively). “Lung function improvements were observed … in patients with late-onset asthma and fixed airway obstruction, who typically experience worse asthma outcomes than those without fixed airway obstruction,” said Hanania.

In addition, those with fixed airway obstruction also showed a remarkably improved pre-bronchodilatorFEV1/FVC and forced expiratory flow rate at 2575 percent with either doses of dupilumab compared with placebo.

Upper respiratory tract infection (18 percent vs 20 percent), injection-site erythema (14 percent vs 6 percent), upper respiratory tract infection (12 percent vs 14 percent), and bronchitis (11 percent vs 14 percent) were the most common treatment-emergent adverse events reported in the dupilumab and the placebo treatment groups.

“The magnitude of effect with dupilumab, for several outcome measures in patients with age at onset of asthma >40 years was consistently greater in patients with a reduced post-bronchodilatorFEV1/FVC,” the researchers said.

 

*Liberty Asthma Quest: Evaluation of dupilumab in patients with persistent asthma 

**FEV1/FVC: Forced expiratory volume in 1 second/forced vital capacity

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Most Read Articles
29 Nov 2019
Metformin Extended Release 500 mg,750 mg, and 1000 mg
Elvira Manzano, Roshini Claire Anthony, 01 Oct 2019

The European Society of Cardiology (ESC) has released five new guidelines at the ESC Congress 2019, recommending an even lower LDL-C* target in patients at very high risk for cardiovascular disease (CVD), and the use of SGLT2** inhibitors and GLP-1*** receptor agonists as first-line treatments in those with diabetes to reduce their CVD risk.

Roshini Claire Anthony, 16 Dec 2016

Five years of extended therapy with the aromatase inhibitor (AI) letrozole did not improve survival in postmenopausal breast cancer patients, according to findings of the NRG Oncology/NSABP B-42 trial presented at the San Antonio Breast Cancer Symposium (SABCS 2016) held in Texas, US. 

Jackey Suen, 21 Dec 2016

Adding everolimus to fulvestrant in second-line treatment of hormone receptor (HR)-positive, HER2-negative advanced breast cancer improves progression-free survival (PFS) by 40 percent, the phase II PrECOG 0102 study has shown. [SABCS 2016, abstract S1-02]