Dupilumab pharmacokinetics and effect on type 2 biomarkers in children with moderate-to-severe asthma

Jackson, Daniel J.; Bacharier, Leonard B.; Phipatanakul, Wanda; Sher, Lawrence; Domingo, Christian; Papadopoulos, Nikolaos G.; Modena, Brian D.; Li, Ning; Xia, C.; Kamal, Mohamed; Dillon, Myles; Wolfe, Kelley; Gall, Rebecca; Amin, Nikhil; Mannent, Leda; Laws, Elizabeth; Rowe, Paul; Jacob-Nara, Juby; Deniz, Yamo; Lederer, David J.; Hardin, Megan; Xu, Christine

doi:10.1016/j.anai.2023.03.014

Cited by 10 publications

(8 citation statements)

References 43 publications

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“…Dupilumab reduces the rate of severe asthma exacerbations, improves lung function, and enhances asthma control in children with uncontrolled, moderate-to-severe asthma with evidence of type 2 inflammation as identified by blood eosinophils ≥150cells/uL or FeNO ≥20 ppb) (Evidence A). [ 417 418 419 420 ] The dose is 100 mg subcutaneously every 2 weeks or 300 mg subcutaneously every 4 weeks for children <30 Kg and 200 mg subcutaneously every 2 weeks for children ≥30 Kg There are other biologics that have been approved for adult asthmatic population, which is currently investigated for expanded applications in children, readers discretion advised. This line of therapeutics should be initiated by an asthma and allergy specialist.…”

Section: Section 9: Asthma In Childrenmentioning

confidence: 99%

Section: Section 9: Asthma In Childrenmentioning

confidence: 99%

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The Saudi initiative for asthma – 2024 update: Guidelines for the diagnosis and management of asthma in adults and children

Al-Moamary,

Alhaider,

Allehebi

et al. 2023

Annals of Thoracic Medicine

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The Saudi Initiative for Asthma 2024 (SINA-2024) is the sixth version of asthma guidelines for the diagnosis and management of asthma for adults and children that was developed by the SINA group, a subsidiary of the Saudi Thoracic Society. The main objective of the SINA is to have guidelines that are up-to-date, simple to understand, and easy to use by healthcare workers dealing with asthma patients. To facilitate achieving the goals of asthma management, the SINA Panel approach is mainly based on the assessment of symptom control and risk for both adults and children. The approach to asthma management is aligned for age groups: adults, adolescents, children aged 5–12 years, and children aged <5 years. SINA guidelines have focused more on personalized approaches reflecting a better understanding of disease heterogeneity with the integration of recommendations related to biologic agents, evidence-based updates on treatment, and the role of immunotherapy in management. The medication appendix has also been updated with the addition of recent evidence, new indications for existing medication, and new medications. The guidelines are constructed based on the available evidence, local literature, and the current situation at national and regional levels. There is also an emphasis on patient–doctor partnership in the management that also includes a self-management plan.

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Section: Section 9: Asthma In Childrenmentioning

confidence: 99%

Section: Section 9: Asthma In Childrenmentioning

confidence: 99%

The Saudi initiative for asthma – 2024 update: Guidelines for the diagnosis and management of asthma in adults and children

Al-Moamary,

Alhaider,

Allehebi

et al. 2023

Annals of Thoracic Medicine

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“…Dupilumab was approved for the treatment of asthma in patients 6-11 years of age based on a phase 3 VOYAGE efficacy and safety study: compared with placebo, dupilumab reduced the annualized rate of severe asthma exacerbations, improved lung function, and enhanced asthma control in children with uncontrolled, moderate-to-severe asthma with evidence of type 2 inflammation [as identified by blood eosinophils !150 cells/ml or FeNO !20 parts per billion (ppb]) [58]. Further analysis of the VOYAGE study assessed dupilumab pharmacokinetics and the effects on type 2 biomarkers [59]. Results revealed that the weight-tiered dose regimens for children (100 and 200 mg every 2 weeks) achieved mean concentrations within the dupilumab therapeutic range, and similar decreases in type 2 biomarker levels [serum total IgE, serum thymus and activation-regulated chemokine (TARC), blood eosinophil counts, and FeNO] [59].…”

Section: Dupilumabmentioning

confidence: 99%

“…Further analysis of the VOYAGE study assessed dupilumab pharmacokinetics and the effects on type 2 biomarkers [59]. Results revealed that the weight-tiered dose regimens for children (100 and 200 mg every 2 weeks) achieved mean concentrations within the dupilumab therapeutic range, and similar decreases in type 2 biomarker levels [serum total IgE, serum thymus and activation-regulated chemokine (TARC), blood eosinophil counts, and FeNO] [59].…”

Section: Dupilumabmentioning

confidence: 99%

New approaches in childhood asthma treatment

Castagnoli

Brambilla

Giovannini

et al. 2023

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of review This review aims to summarize the most recent advances in asthma management, focusing on novel approaches to pediatric asthma. Recent findings In recent years, the therapeutic tools for pediatric asthma have expanded significantly for both the nonsevere and severe forms. The use of anti-inflammatory treatment, even for the mildest cases, and the withdrawal of symptomatic bronchodilation as monotherapy have been included in the most recent guidelines. Also, different biological therapies have revolutionized the therapeutical approach for severe uncontrolled asthma in children and adolescents. Summary With the expanding landscape of novel therapeutic approaches for pediatric asthma, further evidence is needed to help clinicians choose the best option for patients, particularly those with severe asthma. The identification of novel predictive biomarkers may also help pediatricians in selecting children and adolescents for innovative therapies.

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“…[10][11][12] Dupilumab, a monoclonal antibody, binding to the α-subunit of interleukin IL-4 receptor and thereby blocking the signaling pathway of IL-4 and IL-13, is registered for both the treatment of (moderate to) severe AD (age ≥ 6 months) and severe asthma (age ≥ 6 years). [13][14][15][16][17][18][19] Although effective in both AD and asthma, the clinical impact of dupilumab on multimorbid atopic diseases in children is not well understood, as these diseases are often treated individually. 20 Daily practice studies have shown that dupilumab is effective in the treatment of comorbid asthma in adult AD patients, reporting improvements in Forced Expiratory Volume in 1 second (FEV 1 ) and Fractional exhaled Nitric Oxide (FeNO).…”

Section: Introductionmentioning

confidence: 99%

Effect of dupilumab on asthma and aeroallergen sensitization in pediatric atopic dermatitis patients: Results of the BioDay registry

Rijst,

Groot,

Zuithoff

et al. 2024

Pediatric Allergy Immunology

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BackgroundAtopic dermatitis (AD) is frequently associated with asthma and allergic rhinitis (AR). Dupilumab is an effective treatment for pediatric AD, although the effect on atopic comorbidities in pediatric AD patients is limited.ObjectiveTo investigate the prevalence of asthma and AR in pediatric AD patients starting dupilumab treatment and to evaluate the effect of dupilumab on these comorbidities.MethodsThis study included pediatric AD patients (aged 3–17 years) treated with dupilumab between 2019 and 2023. Patients were screened at baseline by a pulmonologist for the presence of asthma and AR. Screening included evaluation of medical history and current symptoms, spirometry (including Forced Expiratory Volume in 1 s (FEV1)), Fractional exhaled Nitric Oxide (FeNO), and measurement of aeroallergen‐specific IgE levels. In patients diagnosed with comorbid asthma and/or AR, measurements were repeated at weeks 16 and 52. Spirometry measurements, FeNO, and aeroallergen‐specific IgE levels during treatment were analyzed using a covariance pattern model.ResultsEighty‐four patients were included. Asthma was diagnosed in 50 patients (59.5%) and AR in 72 patients (85.7%). Baseline FeNO levels were elevated in both patients with (29.0 ppb (95% CI 22.0–54.0)) and without asthma (26.0 ppb (95% CI 22.0–30.0)). During treatment, FeNO levels decreased (p < .001) and FEV1 scores increased (p < .001) in patients with asthma. In patients with asthma and/or AR, all aeroallergen‐specific IgE levels decreased between 61.3% and 89.1% at 52 weeks of treatment.ConclusionOne year of dupilumab treatment, primarily indicated for AD, resulted in a significant improvement in comorbid asthma and a profound decrease in aeroallergen‐specific IgE levels in patients with asthma and/or AR.

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Dupilumab pharmacokinetics and effect on type 2 biomarkers in children with moderate-to-severe asthma

Cited by 10 publications

References 43 publications

The Saudi initiative for asthma – 2024 update: Guidelines for the diagnosis and management of asthma in adults and children

The Saudi initiative for asthma – 2024 update: Guidelines for the diagnosis and management of asthma in adults and children

New approaches in childhood asthma treatment

Effect of dupilumab on asthma and aeroallergen sensitization in pediatric atopic dermatitis patients: Results of the BioDay registry

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