Structural and functional lung improvement with dupilumab in asthma

Dupilumab induced meaningful improvements in small airway dysfunction, resulting in improved ventilation and lung function, in patients with moderate- to-severe type 2 inflammatory asthma. The safety of dupilumab was similar to placebo in this study and comparable with previously published data on the safety of this agent.

The phase 4 VESTIGE trial (NCT04400318) is an imaging study that investigates the effect of dupilumab on airway inflammation and structural and functional lung changes in adult patients with uncontrolled moderate- to-severe asthma [1]. The study randomised 109 participants 2:1 to dupilumab, 300 mg subcutaneously administered every 2 weeks, or a placebo. Dr George Washko (Brigham and Women’s Hospital, MA, USA) discussed the results after 24 weeks of therapy.

The positive change from baseline to week 24 in pre- and post-bronchodilator FEF25– 75% was significantly higher in participants treated with dupilumab than in those who received placebo (P<0.001; P<0.01). “The effect was apparent as early as 4 weeks after treatment initiation,” added Dr Washko. Also, the airway wall thickness was significantly reduced in the dupilumab arm compared with the placebo arm after 24 weeks. Furthermore, both in the lower lung and in the upper lung, the increase from baseline to week 24 in ventilation/perfusion at total lung capacity was significantly larger in the dupilumab arm compared with the placebo arm (P<0.05; P<0.05).

Finally, the reduction from baseline to week 24 in mucus plug score was significantly larger in participants on dupilumab versus placebo (P<0.001).

1. Washko GR, et al. Effect of dupilumab on airway oscillometry, ventilation/perfusion, and mucus plugging in moderate-to-severe asthma: the VESTIGE trial. Late-breaking abstracts: science that will impact clinical care. ATS 2024, 17–22 May, San Diego, USA.

Medical writing support was provided by Robert van den Heuvel.

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Posted on 10 June 202410 June 2024