Real-world effectiveness of dupilumab in patients with asthma

杜皮鲁玛 医学 哮喘 恶化 呼出气一氧化氮 内科学 药方 回顾性队列研究 支气管收缩 药理学
作者
Michael S. Blaiss,Eugene R. Bleecker,Juby A. Jacob‐Nara,Radhika Nair,Mei Sheng Duh,Zhixiao Wang,Richard H. Stanford,Xavier Soler,Megan Hardin,Mingchen Ye,Anamika Khanal,Kinga Borsos
出处
期刊:Annals of Allergy Asthma & Immunology [Elsevier BV]
卷期号:132 (4): 463-468.e1 被引量:6
标识
DOI:10.1016/j.anai.2023.11.006
摘要

Background Dupilumab is approved as an add-on maintenance therapy for patients (≥6 years) with moderate-to-severe asthma. Better understanding of real-world effectiveness is needed. Objective To characterize the real-world effectiveness of dupilumab in asthma management. Methods This retrospective study included patients (≥12 years of age) diagnosed with asthma, initiating dupilumab between November 2018 and September 2020. The study used a US electronic medical record database (TriNetX Dataworks, Cambridge, Massachusetts). Asthma exacerbation rates before and after the initiation of dupilumab were analyzed using generalized estimating equations models with Poisson probabilistic link to estimate incidence rate ratios (IRRs). Sensitivity analyses were conducted based on previous exacerbation data, eosinophil levels, history of atopic dermatitis or chronic rhinosinusitis with nasal polyps, previous use of biologics, and presence of SARS-CoV-2 (COVID-19). Results A total of 2400 patients initiating dupilumab met all study criteria. After initiation of dupilumab, risk of asthma exacerbation was reduced by 44% (IRR, 0.56; 95% CI, 0.47-0.57; P = <0.0001) and systemic corticosteroid prescriptions by 48% (IRR, 0.52; 95% CI, 0.48, 0.56; P = <0.0001) compared with those before initiation of dupilumab. Adjustment for COVID-19 showed a greater reduction in asthma exacerbations (IRR, 0.50; 95% CI, 0.45-0.55; P = <0.0001). Conclusion Current real-world efficacy evidence indicates that dupilumab reduces asthma exacerbations and total systemic corticosteroid prescriptions in clinical practice. The effectiveness of dupilumab was observed independent of exacerbation history, eosinophil levels, or COVID-19 impact.
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