Abstract

Background: Dupilumab has proven effective in severe asthma, but there is only sparse evidence on its impact on asthma control in a real-world setting. Materials and methods: All patients from the German Asthma Net (GAN) severe asthma registry who initiated dupilumab after inclusion into the registry were analyzed. Clinical effectiveness was evaluated in those with at least 2 follow-up visits, with a maximum followup time of 3 years. Results: A total of 481 patients with severe asthma initiated dupilumab. At baseline, median blood eosinophil count was 174 cells/μL (IQR 61.2 – 436); 184 (38.3%) were former smokers with median 9.6 pack-years (IQR 4.3 – 23.3). Clinical effectiveness was evaluated in 235 patients. The FEV1 increase from baseline was maintained over the whole study period (+300 mL at 4 months and 1 year, +200 mL at 2 and 3 years, all p < 0.0001). The frequency of exacerbations decreased, and the Asthma Control Test score increased from baseline clinically significantly at all timepoints (+4.3 at 4 months, +4.9 points at 1 year, +5.3 points at 2 years, and +4.6 points at 3 years, all p < 0.0001). Dupilumab was well tolerated; < 10% of patients reported adverse events or discontinued dupilumab treatment. The only adverse events recorded in more than 1 patient were conjunctivitis (4 patients), joint pain (3 patients), and flu-like symptoms (2 patients). Conclusion: In this large real-life study of dupilumab in patients with severe asthma dupilumab showed long-term clinical effectiveness for up to 3 years, with results consistent with prior randomized controlled trials.

Author Details

Authors

• Andreas Renner¹,²
• Slagjana Stoshikj¹,²
• Eckard Hamelmann³
• Dirk Skowasch⁴
• Christian Schulz⁵
• Margret Jandl⁶
• Olaf Schmidt⁷
• Katrin Milger⁸,⁹
• Rainer Ehmann¹⁰
• Christian Taube¹¹
• Stephanie Korn¹²
• Roland Buhl¹³
• Marco Idzko¹,²
• the German Asthma Net (GAN) study group

Departments

• ¹ Department of Pneumology, Medical University of Vienna, Vienna, Austria,
• ² Comprehensive Center for Chest Diseases, Medical University of Vienna, Vienna, Austria,
• ³ Kinderzentrum Bethel, Evangelisches Klinikum Bethel, University Bielefeld, Bielefeld,
• ⁴ Department of Internal Medicine II - Pneumology, University Hospital Bonn, Bonn,
• ⁵ Department of Internal Medicine II, University Hospital Regensburg, Regensburg,
• ⁶ Hamburger Institut für Therapieforschung GmbH, Hamburg,
• ⁷ Pneumologische Gemeinschaftspraxis und Studienzentrum KPPK, Koblenz, Germany,
• ⁸ Division of Respiratory Medicine, Lung Research Cluster, Department of Internal Medicine, Medical University of Graz, Graz, Austria,
• ⁹ Department of Medicine V, Ludwig-Maximilians-University (LMU) of Munich, Comprehensive Pneumology Center (CPC-M) German Center for Lung Research (DZL), Munich,
• ¹ 
• ⁰ Ambulante Pneumologie mit Allergiezentrum, Stuttgart,
• ¹ 
• ¹ Department of Pulmonary Medicine, University Hospital Essen – Ruhrlandklinik, Essen,
• ¹ 
• ² Department of Pulmonary and Respiratory Critical Care Medicine, Thoraxklinik Heidelberg und IKF Pneumologie Mainz, and
• ¹ 
• ³ Pulmonary Department, Mainz University Hospital, Mainz, Germany

Address

Andreas Renner, MD, Department of Pneumology, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria
Email: [email protected]

Citation