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Fewer exacerbations with dupilumab in COPD with type 2 inflammation

Presented by
Prof. Klaus Rabe, LungenClinic Grosshansdorf GmbH, Germany
Conference
ATS 2023
Trial
Phase 3, BOREAS
Doi
https://doi.org/10.55788/b7e00352
In patients with COPD with type 2 inflammation, dupilumab significantly reduced the annualised exacerbation rate compared with placebo. Lung function tests and patient-reported outcomes confirmed the positive effect of dupilumab in this patient population. 

The phase 3 BOREAS trial (NCT03930732) randomised 939 patients with moderate to severe COPD with type 2 inflammation 1:1 to dupilumab or placebo [1]. The primary outcome was the annualised rate of moderate to severe exacerbations from baseline to week 52. Prof. Klaus Rabe (LungenClinic Grosshansdorf GmbH, Germany) presented the primary results of the trial, which were simultaneously published in the New England Journal of Medicine [2]. 

Although almost all patients were on triple therapy, dupilumab reduced the annualised exacerbation rate by 30% compared with placebo (0.78 vs 1.10; P<0.001). Prof. Rabe showed that this result was consistent across subgroups. Notably, at week 12 the change from baseline least squares means pre-bronchodilator forced expiratory volume in 1 second (FEV1) was 83 ml larger in the experimental group than in the placebo group (P<0.001), and this difference remained stable up to week 52. Similarly, patient-reported outcome measures displayed swift improvements after dupilumab therapy was initiated and these improvements stabilised over time.  

In conclusion, on top of triple therapy, dupilumab was able to reduce the exacerbation rates in patients with COPD with type 2 inflammation in a large phase 3 trial.  

  1. Bhatt SP, et al. Dupilumab for COPD with type 2 inflammation indicated by eosinophil counts. B13, ATS International Conference 2023, 19–24 May, Washington DC, USA.

  2. Bhatt SP, et al. NEJM. 2023; May 21. DOI: 10.1056/NEJMoa2303951.

 

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