1. Dupilumab Reduces Oral Corticosteroid Use in Patients With Corticosteroid-Dependent Severe Asthma: An Analysis of the Phase 3, Open-Label Extension TRAVERSE Trial.
- Author
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Sher, Lawrence D., Wechsler, Michael E., Rabe, Klaus F., Maspero, Jorge F., Daizadeh, Nadia, Mao, Xuezhou, Ortiz, Benjamin, Mannent, Leda P., Laws, Elizabeth, Ruddy, Marcella, Pandit-Abid, Nami, Jacob-Nara, Juby A., Gall, Rebecca, Rowe, Paul J., Deniz, Yamo, Lederer, David J., and Hardin, Megan
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DUPILUMAB ,ASTHMA ,ASTHMATICS ,CORTICOSTEROIDS ,RESEARCH ,ADRENOCORTICAL hormones ,MONOCLONAL antibodies ,EVALUATION research ,BRONCHODILATOR agents ,TREATMENT effectiveness ,COMPARATIVE studies ,RANDOMIZED controlled trials ,BLIND experiment ,SUBCUTANEOUS injections - Abstract
Background: Many patients with severe asthma require chronic corticosteroid treatment to maintain asthma control.Research Question: Are the reduction in oral corticosteroid (OCS) use and the clinical efficacy observed with dupilumab treatment maintained long-term in patients with severe OCS-dependent asthma?Study Design and Methods: The LIBERTY ASTHMA TRAVERSE study (ClinicalTrials.gov identifier: NCT02134028) was a multinational, multicenter, single-arm, open-label extension study in patients ≥ 12 years of age with asthma who participated in previous dupilumab studies. Treatment consisted of dupilumab 300 mg every 2 weeks for up to 96 weeks. In this analysis, we present the data from patients who initially enrolled in the LIBERTY ASTHMA VENTURE study (ClinicalTrials.gov identifier: NCT02528214), a 24-week placebo-controlled study of dupilumab in patients with OCS-dependent severe asthma, and continued in the TRAVERSE study. The subgroups analyzed were: those who received dupilumab in both (dupilumab/dupilumab group) and those who received placebo in the VENTURE study and dupilumab in the TRAVERSE study (placebo/dupilumab group). Outcomes included OCS use, exacerbation rates, and measures of lung function and asthma control.Results: Ninety patients treated with dupilumab/dupilumab and 97 patients treated with placebo/dupilumab in the VENTURE study were enrolled and treated in the TRAVERSE study, with a mean OCS dosage of 11.0 mg/d (dupilumab) and 11.6 mg/d (placebo) at VENTURE study baseline. At TRAVERSE week 0, the mean daily OCS dosage was 3.1 mg/d and 6.4 mg/d (percentage decrease from the VENTURE study baseline, 68.8% and 41.3%) for the dupilumab/dupilumab group and placebo/dupilumab group, respectively, and decreased to 2.2 mg/d and 4.9 mg/d (78.3% and 53.4%) at week 48 and to 1.2 mg/d and 3.0 mg/d (89.3% and 74.4%) at week 96, respectively. Exacerbation rates were low during the TRAVERSE study. Further improvements from the VENTURE to TRAVERSE studies also were seen in FEV1 and 5-item Asthma Control Questionnaire scores. Safety findings were consistent with the known dupilumab safety profile.Interpretation: In the open-label TRAVERSE study, dupilumab demonstrated the ability to sustain the OCS dosage reduction from the parent OCS-sparing study, while maintaining a low exacerbation rate and improved lung function.Trial Registry: ClinicalTrials.gov; Nos.: NCT02134028 (TRAVERSE) and NCT02528214 (VENTURE); URL: www.Clinicaltrials: gov. [ABSTRACT FROM AUTHOR]- Published
- 2022
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