Dupilumab Induces Long-Term On-Treatment Clinical Remission in Patients With Type 2 Asthma.

BACKGROUND: Remission is proposed as a multicomponent outcome for patients with severe asthma. OBJECTIVE: This post hoc analysis of QUEST (NCT02414854) and TRAVERSE (NCT02134028) evaluated whether dupilumab treatment leads to clinical asthma remission (≥12 months with no severe exacerbations, zero oral corticosteroids [OCS] use, stabilized or improved lung function, patient-reported asthma control <1.5) and assessed its durability in patients with uncontrolled, moderate-to-severe type 2 asthma (blood eosinophils ≥150 cells/μL or fractional exhaled nitric oxide ≥20 ppb at parent-study baseline) who are not on maintenance OCS. METHODS: In QUEST, patients (≥12 years) were randomized to dupilumab 200/300 mg or placebo every 2 weeks (q2w) for 52 weeks. In TRAVERSE, all patients received dupilumab 300 mg q2w for up to 96 weeks. We assessed proportion of patients meeting criteria for on-treatment clinical remission up to 48 weeks of TRAVERSE. RESULTS: At QUEST baseline, 1040 patients receiving dupilumab and 544 on placebo had type 2 asthma; of those, 842 (dupilumab/dupilumab) and 437 (placebo/dupilumab) enrolled in TRAVERSE. At QUEST Week 52 (Year 1), 37.2% of patients receiving dupilumab met clinical remission criteria, compared with 22.2% on placebo (all P < .001). At Week 48 of TRAVERSE (Year 2 overall), 42.8% (dupilumab/dupilumab) and 33.4% (placebo/dupilumab) of patients met clinical remission criteria. Overall, 29.5% of patients in the dupilumab/dupilumab group met the criteria at both Years 1 and 2. CONCLUSIONS: Dupilumab treatment enabled approximately one-third of patients with type 2 asthma to meet the multicomponent endpoint for on-treatment clinical asthma remission for up to 2 years.