Dupilumab (DPL), anti-IL-4Rα mAb that inhibits signaling of IL-4/IL-13, key drivers of Type 2/Th2 inflammation is approved for patients aged ≥12 years in the USA with moderate-to-severe AD inadequately controlled by topical prescription treatments or when those therapies are not advisable, adult AD patients in Japan not adequately controlled with existing therapies, and moderate to severe AD patients aged ≥18 years in Europe who are candidates for systemic therapy. We assessed DPL efficacy in adults with concurrent moderate-to-severe AD, asthma, and chronic nasal/paranasal sinus conditions (N/PNS) from 4 phase 3 trials: LIBERTY AD SOLO 1 & 2 (NCT02277743, NCT02277769), CHRONOS (NCT02260986), and CAFÉ (NCT02755649).
Data were pooled for patients with asthma requiring treatment, baseline Asthma Control Questionnaire (ACQ-5) score ≥0.5, and N/PNS (12.7% patients). Patients received subcutaneous DPL 300mg every 2 weeks (q2w; n=95), weekly (qw; n=102) or placebo (PBO, n=114).
At Week 16, dupilumab q2w/qw vs PBO improved (least squares mean decrease from baseline) ACQ-5 (0.53/0.66 vs 0.24; P=0.0242/0.0007), 22-item Sino-Nasal Outcome Test(12.27/13.39 vs 6.47; P=0.0110/0.0017), Eczema Area and Severity Index (77.7%/75.3% vs 35.5%; P<0.0001), and Peak Pruritus Numerical Rating Scale (46.1%/50.7% vs 24%; P<0.0001). Injection-site reactions and conjunctivitis were more common with DPL than PBO.
This subgroup analysis shows that dupilumab-treated AD patients with asthma and N/PNS experienced clinically and statistically significant improvement in all 3 diseases.

Dupilumab Improves Outcomes of Concurrent Asthma and Chronic Sino-Nasal Conditions in Patients With Atopic Dermatitis—a Pooled Analysis of Four Phase 3 Studies (LIBERTY AD SOLO 1 & 2, CHRONOS, and CAFÉ)