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Efficacy of dupilumab on clinical outcomes in patients with asthma and perennial allergic rhinitis

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Abstract
Background: Comorbid perennial allergic rhinitis (PAR) or year-round aeroallergen sensitivity substantially contributes to disease burden in patients with asthma. Dupilumab blocks the shared receptor for interleukin (IL) 4 and IL-13, key drivers of type 2 inflammation that play important roles in asthma and PAR. In the LIBERTY ASTHMA QUEST trial (NCT02414854), dupilumab reduced severe asthma exacerbations and improved forced expiratory volume in 1 second (FEV1) in patients with uncontrolled, moderate-to-severe asthma, with greater efficacy observed in patients with elevated type 2 inflammatory biomarkers at baseline (blood eosinophils and fractional exhaled nitric oxide). Objective: To assess dupilumab efficacy in LIBERTY ASTHMA QUEST patients with comorbid PAR. Methods: Severe asthma exacerbation rates, FEV1, asthma control (5-item Asthma Control Questionnaire), rhinoconjunctivitis-specific health-related quality of life (Standardized Rhinoconjunctivitis Quality of Life Questionnaire +12 scores), and type 2 inflammatory biomarkers during the 52-week treatment period were assessed. Results: A total of 814 of the 1902 patients (42.8%) had comorbid PAR (defined as an allergic rhinitis history and >= 1 perennial aeroallergen specific immunoglobulin E (IgE) level >= 0.35 kU/L at baseline). Dupilumab, 200 and 300 mg every 2 weeks, vs placebo reduced severe exacerbations rates by 32.2% and 34.6% (P <.05 for both) and improved FEV1 at week 12 by 0.14 L and 0.18 L (P <.01 for both); greater efficacy was observed in patients with elevated baseline blood eosinophil counts (>= 300 cells/mL) and fractional exhaled nitric oxide. Dupilumab treatment also numerically improved the 5-item Asthma Control Questionnaire and Standardized Rhinoconjunctivitis Quality of Life Questionnaire +12 scores and suppressed type 2 inflammatory biomarkers. Conclusion: Dupilumab improved key asthma-related outcomes, asthma control, and rhinoconjunctivitisspecific health-related quality of life while suppressing type 2 inflammatory biomarkers and perennial allergen-specific IgE in patients with moderate-to-severe asthma and comorbid PAR, highlighting its dual inhibitory effects on IL-4 and IL-13 and its role in managing asthma and PAR. (C) 2020 American College of Allergy, Asthma & Immunology.
Keywords
PERSISTENT ASTHMA, IMPACT, IL-4, PLACEBO, HUMANIZATION, MANAGEMENT

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MLA
Busse, William W., et al. “Efficacy of Dupilumab on Clinical Outcomes in Patients with Asthma and Perennial Allergic Rhinitis.” ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY, vol. 125, no. 5, 2020, pp. 565–76, doi:10.1016/j.anai.2020.05.026.
APA
Busse, W. W., Maspero, J. F., Lu, Y., Corren, J., Hanania, N. A., Chipps, B. E., … Teper, A. (2020). Efficacy of dupilumab on clinical outcomes in patients with asthma and perennial allergic rhinitis. ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY, 125(5), 565–576. https://doi.org/10.1016/j.anai.2020.05.026
Chicago author-date
Busse, William W, Jorge F Maspero, Yufang Lu, Jonathan Corren, Nicola A Hanania, Bradley E Chipps, Constance H Katelaris, et al. 2020. “Efficacy of Dupilumab on Clinical Outcomes in Patients with Asthma and Perennial Allergic Rhinitis.” ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY 125 (5): 565–76. https://doi.org/10.1016/j.anai.2020.05.026.
Chicago author-date (all authors)
Busse, William W, Jorge F Maspero, Yufang Lu, Jonathan Corren, Nicola A Hanania, Bradley E Chipps, Constance H Katelaris, J Mark FitzGerald, Santiago Quirce, Linda B Ford, Megan S. Rice, Siddhesh Kamat, Asif H. Khan, Alexandre Jagerschmidt, Sivan Harel, Paul Rowe, Gianluca Pirozzi, Nikhil Amin, Marcella Ruddy, Neil M. H Graham, and Ariel Teper. 2020. “Efficacy of Dupilumab on Clinical Outcomes in Patients with Asthma and Perennial Allergic Rhinitis.” ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY 125 (5): 565–576. doi:10.1016/j.anai.2020.05.026.
Vancouver
1.
Busse WW, Maspero JF, Lu Y, Corren J, Hanania NA, Chipps BE, et al. Efficacy of dupilumab on clinical outcomes in patients with asthma and perennial allergic rhinitis. ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY. 2020;125(5):565–76.
IEEE
[1]
W. W. Busse et al., “Efficacy of dupilumab on clinical outcomes in patients with asthma and perennial allergic rhinitis,” ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY, vol. 125, no. 5, pp. 565–576, 2020.
@article{8747028,
  abstract     = {{Background: Comorbid perennial allergic rhinitis (PAR) or year-round aeroallergen sensitivity substantially contributes to disease burden in patients with asthma. Dupilumab blocks the shared receptor for interleukin (IL) 4 and IL-13, key drivers of type 2 inflammation that play important roles in asthma and PAR. In the LIBERTY ASTHMA QUEST trial (NCT02414854), dupilumab reduced severe asthma exacerbations and improved forced expiratory volume in 1 second (FEV1) in patients with uncontrolled, moderate-to-severe asthma, with greater efficacy observed in patients with elevated type 2 inflammatory biomarkers at baseline (blood eosinophils and fractional exhaled nitric oxide).

Objective: To assess dupilumab efficacy in LIBERTY ASTHMA QUEST patients with comorbid PAR.

Methods: Severe asthma exacerbation rates, FEV1, asthma control (5-item Asthma Control Questionnaire), rhinoconjunctivitis-specific health-related quality of life (Standardized Rhinoconjunctivitis Quality of Life Questionnaire +12 scores), and type 2 inflammatory biomarkers during the 52-week treatment period were assessed.

Results: A total of 814 of the 1902 patients (42.8%) had comorbid PAR (defined as an allergic rhinitis history and >= 1 perennial aeroallergen specific immunoglobulin E (IgE) level >= 0.35 kU/L at baseline). Dupilumab, 200 and 300 mg every 2 weeks, vs placebo reduced severe exacerbations rates by 32.2% and 34.6% (P <.05 for both) and improved FEV1 at week 12 by 0.14 L and 0.18 L (P <.01 for both); greater efficacy was observed in patients with elevated baseline blood eosinophil counts (>= 300 cells/mL) and fractional exhaled nitric oxide. Dupilumab treatment also numerically improved the 5-item Asthma Control Questionnaire and Standardized Rhinoconjunctivitis Quality of Life Questionnaire +12 scores and suppressed type 2 inflammatory biomarkers.

Conclusion: Dupilumab improved key asthma-related outcomes, asthma control, and rhinoconjunctivitisspecific health-related quality of life while suppressing type 2 inflammatory biomarkers and perennial allergen-specific IgE in patients with moderate-to-severe asthma and comorbid PAR, highlighting its dual inhibitory effects on IL-4 and IL-13 and its role in managing asthma and PAR. (C) 2020 American College of Allergy, Asthma & Immunology.}},
  author       = {{Busse, William W and Maspero, Jorge F and Lu, Yufang and Corren, Jonathan and Hanania, Nicola A and Chipps, Bradley E and Katelaris, Constance H and FitzGerald, J Mark and Quirce, Santiago and Ford, Linda B and Rice, Megan S. and Kamat, Siddhesh and Khan, Asif H. and Jagerschmidt, Alexandre and Harel, Sivan and Rowe, Paul and Pirozzi, Gianluca and Amin, Nikhil and Ruddy, Marcella and Graham, Neil M. H and Teper, Ariel}},
  issn         = {{1081-1206}},
  journal      = {{ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY}},
  keywords     = {{PERSISTENT ASTHMA,IMPACT,IL-4,PLACEBO,HUMANIZATION,MANAGEMENT}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{565--576}},
  title        = {{Efficacy of dupilumab on clinical outcomes in patients with asthma and perennial allergic rhinitis}},
  url          = {{http://doi.org/10.1016/j.anai.2020.05.026}},
  volume       = {{125}},
  year         = {{2020}},
}

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