Leonard B. Bacharier, MD Janie Robinson and John Moore Lee Chair in Pediatrics Professor of Pediatrics Director - Center for Pediatric Asthma Research Scientific Director - Center for Clinical and Translational Research Section Chief - Pediatric Allergy and Immunology Division of Allergy, Immunology and Pulmonary Medicine

NEJM: Dupilumab for Pediatric Uncontrolled Moderate-to-Severe Asthma

MedicalResearch.com Interview with:

Leonard B. Bacharier, MD Janie Robinson and John Moore Lee Chair in Pediatrics Professor of Pediatrics Director - Center for Pediatric Asthma Research Scientific Director - Center for Clinical and Translational Research Section Chief - Pediatric Allergy and Immunology Division of Allergy, Immunology and Pulmonary Medicine

Dr. Bacharier

Leonard B. Bacharier, MD
Janie Robinson and John Moore Lee Chair in Pediatrics
Professor of Pediatrics
Director – Center for Pediatric Asthma Research
Scientific Director – Center for Clinical and Translational Research
Section Chief – Pediatric Allergy and Immunology
Division of Allergy, Immunology and Pulmonary Medicine
Monroe Carell Jr. Children’s Hospital at Vanderbilt University Medical Center 

MedicalResearch.com: What is the background for this study?  Is Dupilumab used for other atopic conditions, ie eczema/atopic dermatitis?  

Response: Many children with moderate-severe asthma continue to experience asthma exacerbations and poor asthma control despite use of controller therapies.  Dupilumab has been shown to reduce asthma exacerbations in adolescents and adults, as well as to improve atopic dermatitis in children and adults.

MedicalResearch.com: What are the main findings? 

Response: We found that when dupilumab was added to standard therapy in children 6-11 yrs of age with uncontrolled moderate-severe asthma, the rate of severe exacerbations was reduced by more than 50% compared to placebo. These findings were apparent in children with evidence of type 2 inflammation (blood eosinophils 150cells/uL  or higher, or FeNO 20 or higher) or with blood eosinophils 300cells/uL or higher.  In addition, dupilumab treatment led to rapid and sustained increases in lung function as well as improvements in asthma control.

MedicalResearch.com: What should readers take away from your report?

Response: This is the first study to demonstrate that, in children 6-11 years of age, the addition of a biologic( dupilumab) led to improvements in both exacerbations and lung function with an acceptable safety profile. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Additional study is needed to determine the long term efficacy and safety of this approach (ongoing EXCURSION trial is studying this).

 Any disclosures?  I serve as a consultant to Sanofi and Regeneron, the sponsors of this trial.

Citation:

Dupilumab in Children with Uncontrolled Moderate-to-Severe Asthma
Leonard B. Bacharier, M.D., Jorge F. Maspero, M.D., Constance H. Katelaris, M.D., Alessandro G. Fiocchi, M.D., Remi Gagnon, M.D., Ines de Mir, M.D., Neal Jain, M.D., Lawrence D. Sher, M.D., Xuezhou Mao, Ph.D., Dongfang Liu, M.S., Yi Zhang, Ph.D., M.P.H., Asif H. Khan, M.B., B.S., M.P.H.,

 for the Liberty Asthma VOYAGE Investigators
December 9, 2021
N Engl J Med 2021; 385:2230-2240
DOI: 10.1056/NEJMoa2106567

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Last Updated on December 8, 2021 by Marie Benz MD FAAD