Treatment Shows Benefit for Asthma With Comorbid Perennial Allergic Rhinitis

Dupilumab may help optimize the management of patients with asthma and perennial allergic rhinitis (PAR) by providing simultaneous control of both conditions through inhibition of type 2 inflammation. Researchers published their findings in Annals of Allergy, Asthma & Immunology.

“Comorbid PAR or year-round aeroallergen sensitivity substantially contributes to disease burden in patients with asthma,” they explained. “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.”

The study evaluated data from the phase 3 LIBERTY ASTHMA QUEST trial, which tested the efficacy of dupilumab compared with placebo in patients 12 years or older with uncontrolled, moderate-to-severe asthma. The post hoc analysis focused specifically on 814 patients with asthma and comorbid PAR.

Dupilumab 200 mg every 2 weeks reduced severe exacerbation rates by 32.2% and improved forced expiratory volume in 1 second (FEV1) at week 12 by 0.14 L compared with placebo, according to the study. At 300 mg every 2 weeks, dupilumab cut severe exacerbations by 34.6% and improved FEV1 at week 12 by 0.18 L. Patients with elevated baseline blood eosinophil counts and fractional exhaled nitric oxide showed greater benefit with dupilumab.

Dupilumab also improved scores on the 5-item Asthma Control Questionnaire and Standardized Rhinoconjunctivitis Quality of Life Questionnaire +12. Significant suppression of type 2 inflammatory biomarkers, including total serum immunoglobulin E, fractional exhaled nitric oxide, and thymus- and activation-regulated chemokine, accompanied efficacy.

“In conclusion, dupilumab improved key asthma-related outcomes, suppressed type 2 inflammatory biomarkers, and improved rhinoconjunctivitis-related quality of life in patients with uncontrolled, moderate-to-severe asthma and comorbid PAR,” researchers wrote. “Dupilumab was generally well tolerated in the overall study population.”

Reference:
Busse WW, Maspero JF, Lu Y, et al. Efficacy of dupilumab on clinical outcomes in patients with asthma and perennial allergic rhinitis. Ann Allergy Asthma Immunol. 2020;125(5):565-576.e1. doi:10.1016/j.anai.2020.05.026