Efficacy and safety of dupilumab in perennial allergic rhinitis and comorbid asthma

Weinstein, Steven F.; Katial, Rohit; Jayawardena, Shyamalie; Pirozzi, Gianluca; Staudinger, Heribert; Eckert, Laurent; Joish, Vijay N.; Amin, Nikhil; Maroni, Jaman; Rowe, Paul; Graham, Neil M.H.; Teper, Ariel

doi:10.1016/j.jaci.2017.11.051

Cited by 117 publications

(90 citation statements)

References 30 publications

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Section: Other Biologics Which Could Be Of Interest In Children With supporting

confidence: 66%

“…Finally, Weinstein et al recently showed that dupilumab 300 mg every 2 weeks significantly improved allergic rhinitis associated nasal symptoms in patients with uncontrolled persistent asthma and comorbid perennial allergic rhinitis. 44 Considering all these results, we hypothesize that dupilumab could be interesting in children with severe eosinophilic asthma with allergic comorbidities, especially severe atopic dermatitis and allergic rhinitis, and with lung function impairment. (-34% in the tezepelumab arm vs -45.9% in the placebo arm, P < 0.02).…”

Section: Monoclonal Antibodies Directed Against Il-4 and Il-13mentioning

confidence: 94%

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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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Section: Other Biologics Which Could Be Of Interest In Children With supporting

confidence: 66%

Section: Monoclonal Antibodies Directed Against Il-4 and Il-13mentioning

confidence: 94%

New perspectives of childhood asthma treatment with biologics

Just

Deschildre

Lejeune

et al. 2018

Pediatric Allergy Immunology

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“…Dupilumab reduces asthma exacerbations, allows a gradual reduction in the use of OCS, and improves lung function. (101)(102)(103)(104)(105) It is administered subcutaneously, at a recommended dose of 400 mg initially, followed by 200 mg on alternate weeks. For patients using OCS or with comorbidities (atopic dermatitis, nasal polyposis, or eosinophilic esophagitis), the recommended dose is 600 mg initially, followed by 300 mg every 2 weeks.…”

Section: Other Medications For the Treatment Of Severe Asthmamentioning

confidence: 99%

2020 Brazilian Thoracic Association recommendations for the management of asthma

et al. 2020

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The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.

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“…More recently, dupilumab, a fully humanized biologic that targets the IL‐4Rα subunit to inhibit the activity of both IL‐4 and IL‐13 has been developed for airway diseases including chronic rhinosinusitis . In this regard, a double‐blind, placebo‐controlled phase IIb clinical trial of patients with uncontrolled persistent asthma and comorbid AR has demonstrated that 300 mg of dupilumab every 2 weeks as an add‐on therapy to medium‐to‐high‐dose inhaled corticosteroids + long acting beta‐agonists (ICS + LABA) significantly improved the symptoms of AR in these patients, suggesting that dupilumab add‐on therapy may have a role in nasal symptom relief for this important subgroup of patients …”

Section: Treatmentmentioning

confidence: 99%

“…57 Decreased number of ILC2s are observed in peripheral blood after nasal allergen challenge (NAC) and are positively correlated with AR symptoms in birch allergic objects irritated outside of the local birch pollen season. 58 Dupilumab Anti-IL4Rα Subcutaneous 106 activation of DC, basophils and T cells in the peripheral blood following NAC. 60 DCs from patients with AR and asthma display impaired IL-12 and IFN-α production in response to toll-like receptor (TLR) 4 and TLR9 activation, respectively, as well as impaired induction of IL-10-producing CD4 + T cells.…”

Section: Environmental Factorsmentioning

confidence: 99%

Recent developments and highlights in allergic rhinitis

Meng

Wang

Zhang

2019

Allergy

135

105

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Allergic rhinitis (AR) is a disease with high prevalence all over the world and therefore needs to be thoroughly investigated and treated accordingly. The mechanisms underlying the pathology and treatment of AR have been widely studied, but many aspects remain unclear and warrant further investigations. This review presents an overview of recently published papers highlighting the risk factors, mechanisms, and treatment of AR. Additionally, recent studies discussing the role of single nucleotide polymorphism, DNA methylation, regulatory B cells, group 2 innate lymphoid cells, immunotherapy, and biologics in AR are also covered. K E Y W O R D Sallergic rhinitis, biologics, epigenetics, risk factors, treatment | 2321 MENG Et al.

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Efficacy and safety of dupilumab in perennial allergic rhinitis and comorbid asthma

Abstract: Dupilumab 300 mg q2w significantly improved AR-associated nasal symptoms in patients with uncontrolled persistent asthma and comorbid PAR.

Cited by 117 publications

References 30 publications

New perspectives of childhood asthma treatment with biologics

New perspectives of childhood asthma treatment with biologics

2020 Brazilian Thoracic Association recommendations for the management of asthma

Recent developments and highlights in allergic rhinitis

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