REAL-WORLD EFFECTIVENESS OF DUPILUMAB IN REDUCING ORAL AND INHALED CORTICOSTEROID USE AMONG US PATIENTS WITH ASTHMA: ANALYSIS FROM THE HEALTHCARE INTEGRATED RESEARCH DATABASE
Author(s)
Nella Bieszk, PharmD1, Anne-Laure Tardy, PhD2, Richard H. STANFORD, MS, PharmD3, Robert Lubwama, PhD4, Joe Yang, PhD5, Rachel Parry, PharmD, PhD6, Vincent J. Willey, PharmD6, Chia-Chen Teng, MS6, Brian Benett, MBA, MS6, M.S. Blaiss, MD, FACAAI, FAAAAI7;
1Sanofi, Cambridge, MA, USA, 2Sanofi, Gentilly, France, 3AESARA, Chapel Hill, NC, USA, 4Sanofi, Morristown, NJ, USA, 5Regeneron Pharmaceuticals, Inc., Sleepy Hollow, NY, USA, 6Carelon Research, Wilmington, DE, USA, 7Medical College of Georgia at Augusta University, Augusta, GA, USA
1Sanofi, Cambridge, MA, USA, 2Sanofi, Gentilly, France, 3AESARA, Chapel Hill, NC, USA, 4Sanofi, Morristown, NJ, USA, 5Regeneron Pharmaceuticals, Inc., Sleepy Hollow, NY, USA, 6Carelon Research, Wilmington, DE, USA, 7Medical College of Georgia at Augusta University, Augusta, GA, USA
OBJECTIVES: Multiple real-world studies have been published following dupilumab's US approval for moderate-to-severe asthma in 2018; however, current data on corticosteroid usage patterns, particularly for inhaled corticosteroids (ICS), remain limited. This study aimed to assess the impact of dupilumab on ICS and oral corticosteroid (OCS) prescription patterns in real-world US clinical practice.
METHODS: This retrospective cohort study used claims data from the Healthcare Integrated Research Database to identify patients with asthma aged ≥12 years who initiated dupilumab (index date) between October 2021 and July 2024. Patients were included if they had received at least one medium- or high-dose ICS fill in the pre-index period (12 months before index) and had 12 months of continuous enrolment before and after dupilumab initiation. ICS and OCS prescriptions were evaluated in the 12-month pre- and post-index periods and were summarized descriptively.
RESULTS: A total of 3,018 patients (59.9% female) aged 47.7 (16.1) years were included. The proportion of patients with ≥1 OCS fills decreased from 80.9% (n=2,442) in the pre-index period to 58.7% (n=1,773) in the post-index period. Before and after dupilumab initiation, the proportion of patients with ≥1 high-dose ICS fills decreased from 51.6% to 40.3%, and that the medium-dose ICS decreased from 48.4% to 38.1%. Additionally, 17.7% of patients had no ICS prescriptions in the post-index period. Similarly, the proportion of patients with ≥1 controller medication fills decreased from 100% to 87.7%, and reliever medication fills from 80.6% to 65.1% before and after dupilumab initiation.
CONCLUSIONS: This real-world study suggests a reduction in corticosteroid use after dupilumab initiation in asthma patients. While OCS reduction aligns with existing data, the decreased high-dose ICS use and no ICS fills in nearly one-fifth of patients provide novel insights. Given the pre-post design, some observed differences may reflect natural variability or regression to mean rather than dupilumab effect.
METHODS: This retrospective cohort study used claims data from the Healthcare Integrated Research Database to identify patients with asthma aged ≥12 years who initiated dupilumab (index date) between October 2021 and July 2024. Patients were included if they had received at least one medium- or high-dose ICS fill in the pre-index period (12 months before index) and had 12 months of continuous enrolment before and after dupilumab initiation. ICS and OCS prescriptions were evaluated in the 12-month pre- and post-index periods and were summarized descriptively.
RESULTS: A total of 3,018 patients (59.9% female) aged 47.7 (16.1) years were included. The proportion of patients with ≥1 OCS fills decreased from 80.9% (n=2,442) in the pre-index period to 58.7% (n=1,773) in the post-index period. Before and after dupilumab initiation, the proportion of patients with ≥1 high-dose ICS fills decreased from 51.6% to 40.3%, and that the medium-dose ICS decreased from 48.4% to 38.1%. Additionally, 17.7% of patients had no ICS prescriptions in the post-index period. Similarly, the proportion of patients with ≥1 controller medication fills decreased from 100% to 87.7%, and reliever medication fills from 80.6% to 65.1% before and after dupilumab initiation.
CONCLUSIONS: This real-world study suggests a reduction in corticosteroid use after dupilumab initiation in asthma patients. While OCS reduction aligns with existing data, the decreased high-dose ICS use and no ICS fills in nearly one-fifth of patients provide novel insights. Given the pre-post design, some observed differences may reflect natural variability or regression to mean rather than dupilumab effect.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
RWD131
Topic
Real World Data & Information Systems
Disease
SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), STA: Biologics & Biosimilars