New research found that Dupilumab treatment lessened asthma exacerbations.
LIBERTY ASTHMA QUEST was a randomized, double-blind, phase 3 study that evaluated add-on dupilumab (Dupixent, Sanofi/Regeneron) 200 mg/300 mg twice weekly compared with placebo in patients with severe asthma. Dupilumab reduced asthma exacerbations and improved pre-bronchodilator FEV1 among those with uncontrolled, moderate to severe asthma. For the post hoc analysis, researchers assessed dupilumab treatment efficacy in patients with type 2 asthma with and without fungal sensitization.
“Up to 30% of asthma patients show evidence of fungal sensitization characterized by increased asthma severity, a type 2 response, and potential progression to bronchiectasis/fibrosis,” Jonathan Corren, MD, an allergist-immunologist at the David Geffen School of Medicine at UCLA, and colleagues wrote in an abstract presented at the European Academy of Allergy & Clinical Immunology Conference. “Dupilumab, a fully human monoclonal antibody, blocks the shared receptor component for interleukin-4 and interleukin-13, key and central drivers for type 2 inflammation.”
The post hoc analysis included a subpopulation of patients on medium- or high-dose inhaled corticosteroids (ICS) at baseline with fungal sensitization specific to Alternariaalternata, A. fumigatus and Cladosporiumherbarum more than 0.35 IU/mL or without fungal sensitization. Read more here.
Changing Biologics Reduces Exacerbations in Severe Asthma
Patients who began taking or who switched biologics for severe asthma consistently experienced meaningfully reduced exacerbations, according to a real-world analysis published in Annals of Allergy, Asthma & Immunology.
As a result, individual approaches to treatment could improve outcomes, the researchers continued. “This study was an analysis of the ongoing CHRONICLE study, a prospective, real-world, noninterventional study of U.S. adult patients with confirmed severe asthma (SA) treated by allergists/immunologists or pulmonologists,” Chris Ambrose, MD, MBA, franchise head of U.S. medical and respiratory at AstraZeneca, told Healio. “The objective of this analysis was to examine real-world biologic use and associated outcomes among adults receiving biologics, with the overall goal of adding to what is known about the use of biologics to treat severe asthma,” Ambrose said. Read more here.
Carnitines Study Provides New Asthma Insights
The research, culminating in a peer-reviewed study published in the European Respiratory Journal, focused on urine analysis – specifically on carnitines. Carnitines are a type of metabolite – a substance produced or used when the body breaks down food, drugs, chemicals or tissue to make energy. Carnitines in particular are critical in providing energy for the body’s cells, as well as supporting immune responses.
Analyses showed more carnitine present in the urine of severe asthmatics. In other words, the more severely the subjects suffered from asthma, the less effectively their body seemed able to metabolize carnitines.
“These are preliminary results, but we will continue to investigate carnitine metabolism to evaluate its potential as a new asthma treatment target,” says Dr. Stacey Reinke. Read more here.