Dupilumab Efficacy and Safety in Moderate-to-Severe Uncontrolled Asthma

Castro, Mario; Corren, Jonathan; Pavord, Ian; Máspero, Jorge; Wenzel, Sally E.; Rabe, Klaus F.; Busse, William W.; Ford, Linda; Sher, Lawrence; FitzGerald, J. Mark; Katelaris, Constance H.; Tohda, Yuji; Zhang, Bingzhi; Staudinger, Heribert; Pirozzi, Gianluca; Amin, Nikhil; Ruddy, Marcella; Akinlade, Bolanle; Khan, Asif; Chao, Jingdong; Martincova, Renata; Graham, Neil M.H.; Hamilton, Jennifer D.; Swanson, Brian N.; Stahl, Neil; Yancopouloš, George D.; Teper, Ariel

doi:10.1056/nejmoa1804092

Cited by 1,473 publications

(1,490 citation statements)

References 19 publications

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“…Notably, Th2/IL-4 stimulates IgE production and eosinophil activation indirectly by promoting IL-5 production [51]. The role of Th2 in AA may be further elucidated after experimental treatment with targeted therapies, in select individuals with concomitant atopy, with anti-Th2 (anti-IL-4/IL-13) therapies such as dupilumab, currently approved for AD and a possible novel therapy for asthma [52]. …”

Section: Discussionmentioning

confidence: 99%

The Immunological Association between Alopecia Areata and Respiratory Diseases: A Systematic Review

Sung

Choi

Juhász

et al. 2019

Skin Appendage Disord

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Background: While alopecia areata (AA) has been associated with atopy, the immunological relationship is unclear, with the association of specific atopic and systemic respiratory diseases not established. The relationship between T-helper (Th)1-mediated AA and Th2-mediated atopy challenges the conventional Th1/Th2 paradigm of autoimmune disease categorization. Objectives: To determine the association between AA and atopic respiratory diseases in adults and children, and respiratory diseases in general. Method: All primary literature, excluding case reports, were identified within PubMed/MEDLINE, CINAHL, and Web of Science in May 2018 using the following search terms: “(alopecia OR hair loss) AND (respiratory OR pulmonary OR lungs OR asthma OR rhinitis OR bronchitis OR COPD OR atopy OR atopic).” Information from 32 articles meeting the inclusion and exclusion criteria was reviewed. Results: Among the 32 articles identified for inclusion, the prevalence of AA was more strongly associated with allergic rhinitis compared to asthma among pediatric and adult populations. While a significant association was identified between AA, allergic rhinitis, and a late age of onset, the association of AA and asthma remains controversial despite asthma’s prevalence among AA patients. No significant difference was identified with regard to the association of AA and non-atopic respiratory diseases between adult and pediatric patients. Conclusions: Adult and pediatric patients with AA warrant further workup for atopic respiratory diseases such as allergic rhinitis. AA may have an underlying Th2-mediated immunological component, which supports its association with atopic respiratory diseases and provides a new avenue for targeted therapies in select cases.

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Section: Discussionmentioning

confidence: 99%

The Immunological Association between Alopecia Areata and Respiratory Diseases: A Systematic Review

Sung

Choi

Juhász

et al. 2019

Skin Appendage Disord

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“…Biological therapies have entered the market for patients with asthma almost 15 years ago with anti‐IgE as first‐line therapy for patients with severe allergic asthma and urticaria . Recently, other monoclonal antibodies targeting type 2 inflammation have been approved and are available now for patients with eosinophilic asthma, atopic dermatitis, and urticaria . A number of trials have been done with biological therapies for CRSwNP .…”

Section: Introductionmentioning

confidence: 99%

EUFOREA consensus on biologics for CRSwNP with or without asthma

Fokkens

Lund

Bachert

et al. 2019

Allergy

290

288

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This is an open access article under the terms of the Creat ive Commo ns Attri bution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. AbstractNovel therapies such as type 2 targeting biologics are emerging treatment options for patients with chronic inflammatory respiratory diseases, fulfilling the needs of | 2313 FOKKENS Et al.

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“…More recently, the phase 3 DBPC QUEST trial included more than 1900 patients aged ≥12 years with moderate‐to‐severe asthma. Patients who received dupilumab had significantly lower rates of severe asthma exacerbations than those who received placebo, as well as better lung function and asthma control.…”

Section: Other Biologics Which Could Be Of Interest In Children Withmentioning

confidence: 98%

New perspectives of childhood asthma treatment with biologics

Just

Deschildre

Lejeune

et al. 2018

Pediatric Allergy Immunology

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Asthma is no longer considered as a single disease but rather as a syndrome corresponding to different entities and pathophysiologic pathways. A targeted strategy is part of personalized medicine which aims to better define each patient's phenotype and endotype so as to prescribe the most suitable treatment at an individual level. Omalizumab and, more recently, mepolizumab are the first biologics approved for children (6‐18 years). Omalizumab is now widely used to treat severe allergic asthma in children and is highly effective for asthma exacerbations and asthma control with a good safety profile. Moreover, several other drugs—lebrikizumab, dupilumab, tezepelumab, mepolizumab, reslizumab, benralizumab—are used or are being studied in both teenagers and adults and could benefit younger children in the near future. We hypothesize that defining the asthma phenotype/endotype regarding the type and intensity of inflammation, association with allergic or non‐allergic comorbidities, and airway remodeling should contribute to the choice of a specific biologic. Pediatric specificities have to be addressed and validated by studies in children. Long‐term effectiveness and particularly the impact on the natural history of asthma should also be investigated. Severe asthma in children is a complex disease, and patients have to be referred to a specialized pediatric asthma center to confirm diagnosis and initiate the best treatment strategy which could include biologics while taking into account their high cost.

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Dupilumab Efficacy and Safety in Moderate-to-Severe Uncontrolled Asthma

Cited by 1,473 publications

References 19 publications

The Immunological Association between Alopecia Areata and Respiratory Diseases: A Systematic Review

The Immunological Association between Alopecia Areata and Respiratory Diseases: A Systematic Review

EUFOREA consensus on biologics for CRSwNP with or without asthma

New perspectives of childhood asthma treatment with biologics

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