OBJECTIVES: Children with uncontrolled treatment-refractory asthma have poor quality of life (QoL), which also affects their caregivers. Dupilumab blocks interleukin (IL)-4/IL-13 signaling, key and central drivers of type 2 inflammation. In VOYAGE, a 52-week (wk), randomized, double-blind, placebo-controlled phase–3 study (NCT02948959), add-on dupilumab demonstrated efficacy/safety in children aged 6–11 years with uncontrolled moderate-to-severe type 2 asthma. This analysis assessed QoL in caregivers of pediatric participants in VOYAGE.

METHODS: Caregivers of children aged 7–11 years, who received add-on dupilumab or matched placebo by bodyweight, completed the pediatric asthma caregiver QoL questionnaire (PACQLQ) over the study-period. PACQLQ global scores (range 1–7; higher scores indicate better QoL) were analyzed for caregivers of children with type 2 asthma (baseline blood eosinophils ≥150cells/µL or FeNO ≥20ppb; n=318) or with baseline eosinophils ≥300cells/µL (n=239) with post hoc analysis for caregivers of children with comorbid allergic rhinitis (AR) in both groups.

RESULTS: At baseline, 25% of caregivers reported their work was impacted a lot by the child’s asthma. For caregivers of dupilumab- vs placebo-treated children with type 2 asthma, global PACQLQ scores significantly improved by Wk36 and onwards (LS mean difference [LSMD] [95% CI] in change from baseline: 0.40 [0.16;0.64] P=0.0013) and by Wk12 and onwards in caregivers of children with baseline eosinophils ≥300cells/µL (LSMD [95% CI]: 0.34 [0.01;0.67], P=0.0445). Comorbid AR was observed in 77% and 81% of children with type 2 asthma and baseline eosinophils ≥300cells/µL, respectively. For caregivers of these children PACQLQ global score significantly improved as early as Wk12 (type 2-LSMD [95% CI]: 0.41 [0.11;0.72] P=0.0084; eosinophils ≥300cells/µL-LSMD [95% CI]: 0.46 [0.10;0.82] P=0.0127) and beyond for caregivers of dupilumab- vs placebo-treated children.

CONCLUSIONS: Dupilumab treatment of children aged 7-11 years with moderate-to-severe type 2 asthma, including patients with comorbid AR, may improve QoL in the caregivers of these children.