Dupilumab response in severe asthma with coexisting COPD

A nationwide Danish observational study compared 12-month outcomes after dupilumab in 401 patients with severe asthma, including 93 with coexisting COPD. Exacerbations, oral corticosteroid use and symptom scores improved in both groups, but complete response was less common with COPD overlap.

COPD overlap was present in 23% of the cohort.
Exacerbations and symptom scores improved in both groups.
Complete response was less frequent with COPD overlap.
The observational study did not compare alternative treatments.

This nationwide observational study used the Danish Severe Asthma Register to assess dupilumab-treated patients with severe asthma who had complete one-year follow-up. Of 401 patients, 93 (23%) met the study definition of coexisting COPD: age over 40 years, at least 10 pack-years of tobacco exposure and FEV₁/FVC below 0.70. Outcomes at 12 months included exacerbations, maintenance oral corticosteroid (mOCS) dose, ACQ-6 symptom scores and complete response, defined as no exacerbations and no mOCS use.

Mean exacerbations fell by 61% in the severe-asthma-plus-COPD group and 81% in the severe-asthma-only group (p=0.06). Mean daily mOCS doses decreased by 3.1 mg and 4.3 mg, respectively (p=0.46). ACQ-6 scores improved by 0.86 points in both groups (p=0.85). Complete response was achieved by 51% of patients with COPD overlap versus 70% without it (p=0.001).

The findings suggest that patients with COPD overlap can improve during dupilumab treatment, although they may be less likely to meet the study’s composite definition of complete response. The observational comparison does not establish causality or compare dupilumab with other treatments; full-text details were not available in the supplied source.

In practice

In this registry cohort, adults with severe asthma and COPD overlap had reductions in exacerbations, maintenance oral corticosteroid dose and symptom scores after 12 months of dupilumab, broadly similar to those without COPD overlap. However, complete response—defined as no exacerbations and no oral corticosteroid use—was less frequent in the overlap group (51% versus 70%). These observational data may help set expectations, but they do not establish that dupilumab caused the changes or show how it compares with alternative treatments; they do not support changing treatment decisions on their own.

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Source

ERJ Open Research: Effectiveness of dupilumab in patients with severe asthma and coexisting COPD ↗

This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.