OBJECTIVES:

Dupilumab, a fully human monoclonal antibody, blocks the shared receptor component for interleukin-4/-13, key and central drivers of type 2 inflammation in asthma. Patients with oral corticosteroid (OCS)-dependent severe asthma are at increased risk of OCS-related adverse events. This real-world analysis investigated the reduction in OCS use in patients treated with dupilumab, both overall cohort and with OCS-dependent severe asthma.

METHODS:

This was a retrospective, single-arm study of data from the US insurance claims database Avalere and included patients with moderate-to-severe asthma initiating dupilumab treatment. OCS use was examined during the 12-month baseline period and the 12-month follow-up after starting dupilumab. The number of days of OCS use, proportion of patients who used any OCS and who used OCS on ≥90 days, and cumulative OCS dose were evaluated.

RESULTS:

Of 780 patients overall, 141 were OCS-dependent at baseline. Mean (SD) annualized cumulative dose of OCS during the baseline period was 3485.5 (3306.0) mg. Dupilumab reduced the number of days of OCS use (mean [SD]) by 4.5% in the overall cohort and by 24.6% in the OCS-dependent group. The percentage of patients using OCS was reduced by 34.7% in the overall cohort (P < 0.0001) and by 20.6% in the OCS-dependent group (P < 0.0001). The percentage of patients using OCS for ≥90 days was reduced by 27.6% in the overall cohort (P < 0.001) and by 42% in the OCS-dependent group (P < 0.0001). The mean (SD) annualized cumulative OCS dose was reduced by 14.6% in the overall cohort (P < 0.001) and by 33.4%, to 2323.0 (2695.1) mg, in the OCS-dependent group (P < 0.01).

CONCLUSIONS:

Treatment with dupilumab reduced the number of days with OCS use, cumulative dose of OCS and the proportion of patients who used OCS ≥90 days, both in OCS-dependent and overall cohort population.