The long-term effect of dupilumab on dyspnea, sleep, and activity in oral corticosteroid-dependent severe asthma

Background: Severe asthma impacts quality of life (QoL), including dyspnea, sleep, and activity limitation. Dupi-lumab, a fully human monoclonal antibody, blocks the shared receptor component for interleukins-4 and-13, which are key and central drivers of type 2 inflammation. Phase 3 LIBERTY ASTHMA VENTURE (NCT02528214) and LIBERTY ASTHMA TRAVERSE open-label extension (NCT02134028) evaluated dupilumab 300 mg vs placebo every 2 weeks for 24 weeks (VENTURE) and dupilumab only for an additional 48 to 96 weeks (TRAVERSE) in patients with oral corticosteroid (OCS)-dependent severe asthma.Objective: To assess dupilumab's impact on Asthma QoL Questionnaire (AQLQ) items related to breathing symp-toms, sleep, and activity limitation, and on OCS reduction.Methods: The proportion of patients with AQLQ scores of 6 or 7 for breathing symptoms-, sleeping-, and activity -related items in VENTURE and TRAVERSE, together with OCS dose reductions in VENTURE.Results: In VENTURE, significantly greater proportions of dupilumab-vs placebo-treated patients achieved scores of 6 or 7 by week 24 in breathing symptoms-related (42.7%-60.2% vs 22.4%-39.3%), sleeping-related (45.6%-65.0% vs 27.1%-47.7%), and activity-related (44.7%-51.5% vs 22.4%-34.6%) AQLQ items. Improvements were maintained through TRAVERSE in the dupilumab/dupilumab group and increased to dupilumab treatment levels in the placebo/dupilumab group. Significant OCS dose reductions were observed in VENTURE; up to 90% and 60% of dupilumab-treated vs 65% and 41% of placebo-treated patients with AQLQ scores of 6 or 7 in breathing symptoms-, sleeping-, and activity-related items achieved greater than or equal to 50% dose reduction and elimi-nated OCS at week 24, respectively.Conclusion: In patients with severe OCS-dependent asthma, dupilumab improved QoL related to breathing symptoms, sleep, and activity limitation, and reduced OCS use.Trial Registration: ClinicalTrials.gov Identifiers: NCT02528214 and NCT02134028.(c) 2023 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. %S1081-1206(22)X0004-5%202303%130%3%298%304%TYP\gdef\pts@issuepubyear{2023}This is an open access article under the CC BY -NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)