Severe asthma clinical remission after biologic treatment with anti-IL4/IL13: A real-life experience

Respir Med. 2023 Oct:217:107348. doi: 10.1016/j.rmed.2023.107348. Epub 2023 Jul 6.

Abstract

Introduction: Dupilumab, a fully human anti-interleukin-4/interleukin-13 monoclonal antibody, has shown efficacy in many aspects of Type-2 severe asthma management. Currently, we lack real-life studies addressing the achievment of clinical remission in patients treated with this biologic.

Materials and methods: We performed a prospective study enrolling 18 patients with severe asthma treated with Dupilumab. We assessed main clinical, functional and biological severe asthma features at baseline (T0) and after a 1-year course of treatment (T12). Clinical remission was defined at T12 in patients without asthma exacerbations, no oral corticosteroid (OCS) use, ACT ≥ 20 and FEV1 improvement ≥ 100 ml from baseline.

Results: Among total population, 38.9% of patients achieved clinical remission at T12. Anti IL-4/IL-13 treatment significantly reduced asthma exacerbations and OCS use in the overall cohort, with a more pronounced ACT improvement in the remission group. Patients achieving clinical remission went through a step down of the inhalation therapy, suspending long-acting anti-muscarinics administration at T12.

Conclusions: Treatment with anti-IL4/IL13 can induce clinical remission in patients with T2 severe asthma.

Keywords: Dupilumab; Eosinophil; FeNO; Remission; Severe asthma.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Anti-Asthmatic Agents*
  • Asthma*
  • Biological Products* / therapeutic use
  • Humans
  • Interleukin-13
  • Prospective Studies

Substances

  • Interleukin-13
  • Anti-Asthmatic Agents
  • Adrenal Cortex Hormones
  • Biological Products