Dupilumab (Dupixent, Sanofi and Regeneron) vastly lowered exacerbations in comparison with placebo in kids ages 6-11 years who had moderate-to-severe asthma in a fraction 3 trial.
A very human monoclonal antibody, dupilumab also improved lung feature vs placebo by week 12, an development that lasted the length of the 52-week trial.
Dupilumab beforehand had been confirmed to be protected and effective in formative years and adults with moderate-to-severe asthma, sufferers 6 years and older with moderate-to-severe atopic dermatitis, and adults with power rhinosinusitis with nasal polyposis, nonetheless its security and effectiveness for moderate-to-severe asthma within the 6-11 years age team turned into as soon as no longer identified.
Results from the randomized, double-blind VOYAGE watch performed at some level of several worldwide locations were introduced Saturday, July 10, at the European Academy of Hypersensitive reaction and Scientific Immunology (EAACI) Hybrid Congress 2021.
Leonard B. Bacharier, MD, professor of pediatrics, hypersensitivity/immunology/pulmonary treatment at Vanderbilt University Clinical Middle in Nashville, Tennessee, introduced the implications from the trial, which turned into as soon as funded by Sanofi/Regeneron.
Researchers enrolled 408 kids ages 6-11 years with uncontrolled moderate-to-severe asthma. Younger folks on excessive-dose inhaled corticosteroids (ICS) on my own or medium-to-excessive–dose ICS with a second controller were randomly assigned either to add-on subcutaneous dupilumab 100 mg or 200 mg, in accordance with physique weight at watch inaugurate, or to placebo every 2 weeks for 52 weeks.
Analyses were completed in two populations: 350 sufferers with markers of form 2 irritation (baseline blood eosinophils ? 150 cells/?l or fractional exhaled nitric oxide [FeNO] ? 20 ppb) and 259 sufferers with baseline blood eosinophils ? 300 cells/µl.
“The predominant endpoint turned into as soon as the annualized rate of severe asthma exacerbations,” Bacharier acknowledged. “The most well-known secondary endpoint turned into as soon as change in percent predicted prebronchodilator FEV1 [forced expiratory volume at 1 second] from baseline to week 12.”
At week 12, the annualized severe asthma exacerbation rate turned into as soon as lowered by 59% (P < .0001) in kids with blood eosinophils ? 300 cells/µL and outcomes were connected in those with the form 2 inflammatory phenotype in comparison with placebo.
Results also sign a honest appropriate security profile for dupilumab.
| Table. Safety Profile of Dupilumab vs Placebo | ||
| Tournament | Placebo (No. of Sufferers [%]) | Dupilumab (No. of Sufferers [%]) |
| Any Therapy-Emergent Hostile Tournament (TEAE) | 107 (79.9) | 225 (83) |
| Any Therapy-Emergent Extreme Hostile Tournament | 6 (4.5) | 13 (4.8) |
| Any TEAE main to demise | 0 (0) | 0 (0) |
| Any TEAE main to permanent therapy discontinuation | 2 (1.5) | 5 (1.8) |
James M. Tracy, DO, an expert with the American College of Hypersensitive reaction, Asthma, and Immunology, knowledgeable Medscape Clinical Knowledge that adding the dupilumab option for kids within the 6-11 age team is “mountainous.”
Tracy, who turned into as soon as no longer fervent with the watch, acknowledged even supposing omalizumab (Xolair, Genentech) shall be within the market for these kids, dupilumab stands out ensuing from the differ of comorbidities it will manage with.
“[Children] would possibly maybe aloof no longer have the same rhinosinusitis and polyposis that adults would have, nonetheless a huge selection of them have eczema, and this drug with extra than one prongs is extremely necessary and addresses a substantial array of allergic prerequisites,” Tracy acknowledged.
Bigger than 90% of kids within the watch had at the least one concurrent form 2 inflammatory situation, along side atopic dermatitis and eosinophilic esophagitis. Dupilumab blocks the shared receptor for interleukin (IL)-4/IL-13, that are key drivers of form 2 irritation in extra than one ailments.
Tracy acknowledged that whereas dupilumab is not any longer the supreme drug within the market to manage with kids 6-11 years with moderate-to-severe asthma, it’s miles “a important and uncommon addition to the armamentarium of the particular person practitioner taking care of those very severe asthmatics within the 6-11 age team.”
Dupilumab also ended in hasty and sustained development in lung feature. At 12 weeks, kids assigned dupilumab improved their lung feature as measured by FEV1 by 5.21% (P = .0009), and that persevered thru the 52-week watch duration.
“What all individuals is conscious of is the [improved lung function] discontinue is sustained. What we do not know is how prolonged you wish preserve on the drug for a extra permanent discontinue, which is a self-discipline for all these biologics,” Tracy acknowledged.
Bacharier reported speaker charges and compare beef up from Sanofi/Regeneron. Tracy has disclosed no relevant financial relationships.
European Academy of Hypersensitive reaction and Scientific Immunology (EAACI) Hybrid Congress 2021: Poster #938. Equipped July 10, 2021.
Marcia Frellick is a contract journalist based in Chicago. She has beforehand written for the Chicago Tribune, Science Knowledge, and Nurse.com, and turned into as soon as an editor at the Chicago Sun-Cases, the Cincinnati Enquirer, and the St. Cloud (Minnesota) Cases. Apply her on Twitter at @mfrellick.
For additional info, note Medscape on Fb, Twitter, Instagram, and YouTube.
