Dupilumab improves long-term asthma control in German patients with severe asthma: Real-world data

Dupilumab has proven effective in severe asthma, but there is only sparse evidence on its impact on asthma control in a real-world setting.

All patients from the German Asthma Net (GAN) severe asthma registry who initiated dupilumab after inclusion into the registry were analyzed. Clinical effectiveness was evaluated in those with at least 2 follow-up visits, with a maximum follow-up time of 3 years.

A total of 481 patients with severe asthma initiated dupilumab. At baseline, median blood eosinophil count was 174 cells/µL (IQR 61.2 - 436); 184 (38.3%) were former smokers with median 9.6 pack-years (IQR 4.3 - 23.3). Clinical effectiveness was evaluated in 235 patients. The FEV₁ increase from baseline was maintained over the whole study period (+300 mL at 4 months and 1 year, +200 mL at 2 and 3 years, all p < 0.0001). The frequency of exacerbations decreased, and the Asthma Control Test score increased from baseline clinically significantly at all timepoints (+4.3 at 4 months, +4.9 points at 1 year, +5.3 points at 2 years, and +4.6 points at 3 years, all p < 0.0001). Dupilumab was well tolerated; < 10% of patients reported adverse events or discontinued dupilumab treatment. The only adverse events recorded in more than 1 patient were conjunctivitis (4 patients), joint pain (3 patients), and flu-like symptoms (2 patients).

In this large real-life study of dupilumab in patients with severe asthma dupilumab showed long-term clinical effectiveness for up to 3 years, with results consistent with prior randomized controlled trials.