Authors: Alessandro G. Fiocchi, Wanda Phipatanakul, Robert S. Zeiger, Sandy R. Durrani, Jeremy Cole, Jérôme Msihid, Rebecca Gall, Juby A. Jacob-Nara, Yamo Deniz, Paul J. Rowe, David J. Lederer, Megan Hardin, Yi Zhang, Asif H. Khan
Published: 2023-09-21
DOI: 10.1183/13993003.00558-2023
Source: Full article
BackgroundDupilumab has shown long-term treatment benefits in children with uncontrolled asthma. We assessed in more detail the impact of dupilumab on asthma control and health-related quality of life (HRQoL) in children and their caregivers.MethodsChildren aged 6–11 years with uncontrolled moderate-to-severe type 2 asthma (baseline blood eosinophils ≥150 cells·µL−1or fractional exhaled nitric oxide ≥20 ppb; n=350) were treated with dupilumab or placebo for 52 weeks in the VOYAGE study. Primary outcomes of these analyses were asthma control (change from baseline in Asthma Control Questionnaire 7 Interviewer-Administered (ACQ-7-IA) and achieving a clinically meaningful response of ≥0.5 points); proportion of patients achieving well-controlled asthma or better (ACQ-7-IA ≤0.75 points); effect on patients’ (Standardised Paediatric Asthma Quality of Life Questionnaire Interviewer-Administered (PAQLQ(S)-IA)) and caregivers’ (Paediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ)) HRQoL; and allergic rhinitis-related QoL.ResultsDupilumabversusplacebo significantly improved children's ACQ-7-IA scores by week 4 with sustained improvements through week 52 (least squares mean difference at week 52: −0.44, 95% CI −0.59– −0.30; p<0.0001); a higher proportion achieved a clinically meaningful response (week 52: 86%versus75%; p=0.0051). At weeks 24 and 52, more children who received dupilumab achieved well-controlled asthma (ACQ-7-IA ≤0.75 points: 61%versus43%; p=0.0001 and 70%versus46%; p<0.0001, respectively). Significant improvements in PAQLQ(S)-IA and PACQLQ scores were observed by week 52.ConclusionsIn children aged 6–11 years with moderate-to-severe type 2 asthma, dupilumab treatment was associated with rapid, sustained improvements in asthma control. HRQoL was significantly improved for children and their caregivers.