Dupilumab Efficacy on Asthma Functional, Inflammatory, and Patient-Reported Outcomes across Different Disease Phenotypes and Severity: A Real-Life Perspective
Marco Caminati,
Matteo Maule,
Roberto Benoni,
Diego Bagnasco,
Bianca Beghè,
Fulvio Braido,
Luisa Brussino,
Paolo Cameli,
Maria Giulia Candeliere,
Giovanna Elisiana Carpagnano,
Giulia Costanzo,
Claudia Crimi,
Mariella D’Amato,
Stefano Del Giacco,
Gabriella Guarnieri,
Mona-Rita Yacoub,
Claudio Micheletto,
Stefania Nicola,
Bianca Olivieri,
Laura Pini,
Michele Schiappoli,
Rachele Vaia,
Andrea Vianello,
Dina Visca,
Antonio Spanevello,
Gianenrico Senna
Affiliations
Marco Caminati
Department of Medicine, University of Verona, Piazzale L.A. Scuro, 37134 Verona, Italy
Matteo Maule
Department of Medicine, University of Verona, Piazzale L.A. Scuro, 37134 Verona, Italy
Roberto Benoni
Department of Diagnostics and Public Health, University of Verona, 37129 Verona, Italy
Diego Bagnasco
Allergy and Respiratory Diseases Clinic, IRCCS Policlinico San Martino, University of Genoa, 16132 Genoa, Italy
Bianca Beghè
AOU of Modena, University of Modena and Reggio Emilia, 41125 Modena, Italy
Fulvio Braido
Allergy and Respiratory Diseases Clinic, IRCCS Policlinico San Martino, University of Genoa, 16132 Genoa, Italy
Luisa Brussino
SCDU Immunologia e Allergologia, AO Ordine Mauriziano di Torino, 10137 Torino, Italy
Paolo Cameli
Respiratory Diseases and Lung Transplantation Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
Maria Giulia Candeliere
Allergy and Respiratory Diseases Clinic, IRCCS Policlinico San Martino, University of Genoa, 16132 Genoa, Italy
Giovanna Elisiana Carpagnano
Institute of Respiratory Disease, Department Translational Biomedicine and Neuroscience, University “Aldo Moro”, 70121 Bari, Italy
Giulia Costanzo
Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
Claudia Crimi
Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy
Mariella D’Amato
Respiratory Department, Monaldi Hospital AO Dei Colli, Federico II University, 80131 Naples, Italy
Stefano Del Giacco
Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
Gabriella Guarnieri
Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35122 Padova, Italy
Mona-Rita Yacoub
Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
Claudio Micheletto
Pulmonology Unit, Verona Integrated University Hospital, 37126 Verona, Italy
Stefania Nicola
SCDU Immunologia e Allergologia, AO Ordine Mauriziano di Torino, 10137 Torino, Italy
Bianca Olivieri
Allergy Unit and Asthma Center, Verona Integrated University Hospital, 37126 Verona, Italy
Laura Pini
Respiratory Medicine Unit, ASST—“Spedali Civili” of Brescia, 25123 Brescia, Italy
Michele Schiappoli
Allergy Unit and Asthma Center, Verona Integrated University Hospital, 37126 Verona, Italy
Rachele Vaia
Department of Medicine, University of Verona, Piazzale L.A. Scuro, 37134 Verona, Italy
Andrea Vianello
Respiratory Department, Monaldi Hospital AO Dei Colli, Federico II University, 80131 Naples, Italy
Dupilumab is currently approved for the treatment of Type 2 severe asthma and chronic rhinosinusitis with nasal polyps (CRSwNP). Few studies have specifically reported on dupilumab efficacy on asthma outcomes as a primary objective in a real-life setting, in patients with and without CRSwNP. Our study aimed to explore the efficacy of dupilumab on functional, inflammatory, and patient-reported outcomes in asthma patients across different disease phenotypes and severity, including mild-to-moderate asthma coexisting with CRSwNP. Data from 3, 6, and 12 months follow-up were analyzed. Asthma (FEV1%, Tiffeneau%, ACT, FeNO, oral steroid use, exacerbation rate, and blood eosinophilia) and polyposis (SNOT22, VAS, NPS) outcomes showed a rapid (3 months) and sustained (6 and 12 months) significant change from baseline, despite most of the patients achieving oral steroid withdrawal. According to the sensitivity analysis, the improvement was not conditioned by either the presence of polyposis or severity of asthma at baseline. Of note, even in the case of milder asthma forms, a significant further improvement was recorded during dupilumab treatment course. Our report provides short-, medium-, and long-term follow-up data on asthma outcomes across different diseases phenotypes and severity, contributing to the real-world evidence related to dupilumab efficacy on upper and lower airways T2 inflammation.
