Approval Probability
TA Base Rate
Adjusted LOA
ML Risk
Dupilumab · 21 trials · 12 indications
Worst-Itch numerical rating score (WI-NRS) is a patient report outcome (PRO) comprised of a single item rated on a scale from 0 ("No itch") to 10 ("Worst imaginable itch").
Concentration of dupilumab in serum over time
Annualized rate of severe asthma exacerbations during the 52-week treatment period.
Incidence of TEAEs, SAEs, AESIs, and AEs leading to permanent treatment discontinuation.
The NPS was the sum of the right and left nostril scores and assessed by central video recordings of bilateral nasal endoscopy. For each nostril, NPS was graded based on polyp size which ranged from 0: no polyps, 1: small polyps in the middle meatus not reaching below the inferior border of the middle turbinate, 2: polyps reaching below the lower border of the middle turbinate, 3: large polyps reaching the lower border of the inferior turbinate or polyps medial to the middle turbinate, 4: large polyps causing complete obstruction of the inferior nasal cavity. Total NPS was the sum of right and left nostril scores; ranged from 0 (no polyps) to 8 (large polyps). Higher scores indicated more severe disease. Baseline was defined as the last available value before randomization.
Blood samples were collected at specified timepoints to obtain dupilumab concentration.
WI-NRS is a patient reported outcome (PRO) comprised of a single item rated on a scale from 0 ("No itch") to 10 ("Worst imaginable itch").
WI-NRS is a PRO comprised of a single item rated on a scale from 0 ("No itch") to 10 ("Worst imaginable itch").
For patients that can undergo a methacholine challenge, one doubling dose improvement in PC20 methacholine. For those that cannot undergo a methacholine challenge a 50% reduction in FEV1 reversibility.
The IGA is an assessment instrument used to rate the severity of AD globally based on a 5-point scale ranging from (0 = clear; 1 = almost clear; 2 = mild; 3 = moderate; 4 = severe), higher score indicated higher severity.
An adverse event (AE) was any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product and which did not necessarily have to have a causal relationship with this treatment. TEAEs were AEs that developed or worsened or became serious during the TEAE period.
FEV1 was the volume of air (in liters) exhaled from the lungs in the first second of a forced expiration as measured by spirometer. Spirometry was performed after a wash out period of bronchodilators according to their action duration. Baseline was defined as the last available measurement prior to the first study treatment dose if the participant was treated, or the last available value up to enrollment if the participant was not exposed to study treatment in the current study.
A severe asthma exacerbation event was defined as a deterioration of asthma during the 52-week treatment period requiring: use of systemic corticosteroids for \>=3 days; and/or hospitalization or emergency room visit because of asthma requiring systemic corticosteroid treatment. Annualized event rate was defined as the total number of severe exacerbation events that occurred during the 52-week treatment period divided by the total number of participant-years followed in the 52-week treatment period.
A severe asthma exacerbation event was defined as a deterioration of asthma during the 52-week treatment period requiring: use of systemic corticosteroids for \>=3 days; and/or hospitalization or emergency room visit because of asthma requiring systemic corticosteroid treatment. Annualized event rate was defined as the total number of severe exacerbation events that occurred during the 52-week treatment period divided by the total number of participant-years followed in the 52-week treatment period.
Percentage reduction of OCS dose was calculated as (optimized OCS dose \[mg/day\] at baseline - final OCS dose at Week 24)/optimized OCS dose at baseline x 100. Result is presented as Least Squares Mean (Standard Error) percentage reduction from baseline derived from ANCOVA model with missing data multiply imputed.
The Primary Outcome Measure (Percentage Reduction From Baseline in Oral Corticosteroids Dose at Week 24 While Maintaining Asthma Control) is summarized above, as LS Mean (SE). Table below provides a supplementary presentation of the Primary Outcome Measure data; result is presented as median (inter-quartile range). Percentage reduction of OCS dose was calculated as (optimized OCS dose \[mg/day\] at baseline - final OCS dose at Week 24)/optimized OCS dose at baseline x 100.
A severe exacerbation was defined as a deterioration of asthma requiring: use of systemic corticosteroids for \>=3 days; or hospitalization or emergency room visit because of asthma, requiring systemic corticosteroids. Annualized event rate was the total number of exacerbations that occurred during the treatment period divided by the total number of participant-years treated.
FEV1 was the volume of air exhaled in the first second of a forced expiration as measured by spirometer.
An Adverse Event (AE) was any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product and which did not necessarily had to have causal relationship with treatment. TEAEs were defined as AEs that developed, worsened, or became serious during the treatment emergent AE period (time from first dose of investigational medicinal product \[IMP\] in LTS12551 up to the last dose of dupilumab plus 14 weeks). A Serious AE (SAE) was any untoward medical occurrence that at any dose: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect, was a medically important event.
Clinical response by modified Mayo score is defined as a decrease from baseline in the modified Mayo score of ≥2 points and at least a 30% reduction from baseline, and a decrease in rectal bleeding subscore of ≥1 OR an absolute rectal bleeding subscore of 0 or 1. The modified Mayo score consists of 3 subscores; a patient-reported subscore for rectal bleeding, a patient-reported subscore for stool frequency, and a Mayo endoscopic subscore. Each subscore ranges 0-3 with higher scores indicating greater disease severity. The total modified Mayo score ranges 0-9 with higher scores indicating greater disease severity.
NPS was the sum of the right and left nostril scores, as evaluated by means of nasal endoscopy. Total score ranges from 0 to 8 (scored 0 \[no polyp\] to 4 \[large polyps\] for each nostril), with a lower score indicating smaller-sized polyps.
FEV1 was the volume of air exhaled in the first second of a forced expiration as measured by spirometer.
FEV1 was the volume of air exhaled in the first second of a forced expiration as measured by spirometer.
An asthma exacerbation was defined as the occurrence of any of the following: ≥30% reduction from baseline in morning PEF on 2 consecutive days; or ≥6 additional reliever puffs of albuterol or levalbuterol in a 24-hour period (compared to baseline) on 2 consecutive days; or deterioration of asthma, as determined by the investigator, requiring systemic steroid treatment, or an increase in inhaled corticosteroid (ICS) of ≥4 times the last dose received prior to discontinuation from the study, or hospitalization. The occurrence of asthma exacerbations by individual criteria are reported.
| Arm | Type | Description |
|---|---|---|
| Dupilumab | EXPERIMENTAL | Dupilumab subcutaneous injection as per protocol |
| Placebo | PLACEBO_COMPARATOR | Placebo subcutaneous injection as per protocol |
| Dupilumab (double-blind period) | EXPERIMENTAL | Dupilumab subcutaneous injection as per protocol |
| matched placebo | PLACEBO_COMPARATOR | Sterile placebo for dupilumab will be provided in identically matched glass prefilled syringes to deliver 2 mL. |
| Placebo Q2W | PLACEBO_COMPARATOR | Placebo matched to dupilumab 600 milligrams (mg) (loading dose), subcutaneously (SC) on Day 1 followed by placebo matched to dupilumab 300 mg once every 2 weeks (Q2W) for 16 weeks. |
| Dupilumab 300 mg Q2W | EXPERIMENTAL | Dupilumab at a loading dose of 600 mg, SC on Day 1 followed by 300 mg, Q2W for 16 weeks. |
| Placebo (for Dupilumab 200 mg) q2w | PLACEBO_COMPARATOR | 2 subcutaneous injections of matched Placebo (for Dupilumab 200 mg) as a loading dose on Day 1 (Week 0), followed by a single injection every 2 weeks (q2w) from Week 2 to Week 50 in combination with stable ICS and up to 2 other controller medicines. Albuterol/salbutamol or levalbuterol/levosalbutamol was given as reliever medication. |
| Dupilumab 200 mg q2w | EXPERIMENTAL | 2 subcutaneous injections of Dupilumab 200 mg (for a total of 400 mg) as a loading dose on Day 1 (Week 0), followed by a single 200 mg injection q2w from Week 2 to Week 50 in combination with stable ICS and up to 2 other controller medicines. Albuterol/salbutamol or levalbuterol/levosalbutamol was given as reliever medication. |
| Placebo (for Dupilumab 300 mg) q2w | PLACEBO_COMPARATOR | 2 subcutaneous injections of matched Placebo (for Dupilumab 300 mg) as a loading dose on Day 1 (Week 0), followed by a single injection q2w from Week 2 to Week 50 in combination with stable ICS and up to 2 other controller medicines. Albuterol/salbutamol or levalbuterol/levosalbutamol was given as reliever medication. |
| dupilumab treatment | EXPERIMENTAL | For participants coming from the DRI12544 study: dupilumab loading dose subcutaneous (SC) on Day 1, followed by 1\* Dose every 2 weeks added to current controller medications. For participants coming from other studies: dupilumab 1 \* Dose SC every 2 weeks added to current controller medications. |
| Open-label arm (optional) | OTHER | Regular administration of open label dupilumab |
| Dupilumab 300 mg QW | EXPERIMENTAL | Dupilumab, 2 Subcutaneous injections on Day 1 as a loading dose for a total of 600 mg, followed by a single 300 mg injection QW from Week 1 to 15 added to MFNS. |
| Dupilumab 300 mg q4w | EXPERIMENTAL | 2 subcutaneous injections of Dupilumab 300 mg (for a total of 600 mg) as a loading dose on Day 1 (Week 1) followed by a Placebo alternating with single 300 mg injection of Dupilumab q2w from Week 2 to Week 22 added to stable ICS/LABA therapy. Salbutamol/albuterol or Levosalbutamol/levalbuterol was given as reliever medication. |
| Dupilumab 200 mg q4w | EXPERIMENTAL | 2 subcutaneous injections of Dupilumab 200 mg (for a total of 400 mg) as a loading dose on Day 1 (Week 1) followed by a Placebo alternating with single 200 mg injection of Dupilumab q2w from Week 2 to Week 22 added to stable ICS/LABA therapy. Salbutamol/albuterol or Levosalbutamol/levalbuterol was given as reliever medication. |
| Placebo (for Dupilumab) | PLACEBO_COMPARATOR | Placebo (for Dupilumab) subcutaneous (SC) injection once weekly (qw) for 12 weeks added to background therapy of inhaled corticosteroids/long-acting beta2-adrenergic agonist (ICS/LABA) (Fluticasone/Salmeterol combination therapy at stable dose for 4 weeks followed by Fluticasone monotherapy, dose progressively decreased and discontinued at Week 9). Albuterol or Levalbuterol was given as rescue medication. |
| New dupilumab product | EXPERIMENTAL | A single subcutaneous injection on Day 1 |
| Current dupilumab product | ACTIVE_COMPARATOR | A single subcutaneous injection on Day 1 |
| Dupilumab drug product 1 | ACTIVE_COMPARATOR | A single subcutaneous injection on Day 1 |
| Dupilumab drug product 2 | EXPERIMENTAL | A single subcutaneous injection on Day 1 |
| Name | Type | Description |
|---|---|---|
| Dupilumab | DRUG | Pharmaceutical form: Solution for injection Route of administration: subcutaneous injection |
| Placebo | DRUG | Pharmaceutical form: Solution for injection Route of administration: subcutaneous injection |
| Budesonide | DRUG | nasal spray (suspension) |
| Fexofenadine (loratadine if not available) | DRUG | Tablet or capsule Oral |
| Dupilumab/Dupixent | BIOLOGICAL | a monoclonal antibody designed for the treatment asthma and atopic dermatitis. |
| Emollient (moisturizer) | DRUG | Pharmaceutical form: cream, Route of administration: topical use |
| Dupilumab (SAR231893/REGN668) | DRUG | Pharmaceutical form: solution for injection Route of administration: subcutaneous (sc) |
| Asthma controller therapies (incl. prednisone/prednisolone) | DRUG | Pharmaceutical form: powder, or solution, or pill Route of administration: inhaled, oral or parenteral |
| Asthma reliever therapies | DRUG | Pharmaceutical form: powder or solution Route of administration: inhaled |
| Asthma Controller Therapies | DRUG | Pharmaceutical form: Aerosol, capsules, tablets, oral solution Route of administration: Inhaled, oral |
| Oral corticosteroid therapy (prednisone/prednisolone) | DRUG | Oral administration. |
| Inhaled corticosteroid (ICS) therapy | DRUG | Oral inhalation, stable dose (high dose) of ICS in combination with up to 2 other controller medicines (second or third controller therapy). |
| Albuterol/Salbutamol | DRUG | Oral inhalation as needed. |
| Levalbuterol/Levosalbutamol | DRUG | Oral inhalation as needed. |
| Placebo (for dupilumab) | DRUG | Solution for injection; Subcutaneous injection. |
| Mometasone furoate nasal spray | DRUG | Nasal spray, 2 actuations in each nostril twice daily. |
| ICS/LABA therapy | DRUG | Oral inhalation, Prior therapy with Mometasone furoate /formoterol, budesonide / formoterol, or fluticasone propionate / salmeterol continued at stable dose |
| Salbutamol/albuterol | DRUG | Oral inhalation as needed |
| Levosalbutamol/levalbuterol | DRUG | Oral inhalation as needed |
| Fluticasone/Salmeterol combination therapy | DRUG | Oral inhalation twice daily. |
| Fluticasone monotherapy | DRUG | Oral inhalation twice daily. |
| Albuterol | DRUG | Oral inhalation as needed. |
| Levalbuterol | DRUG | Oral inhalation as needed. |
| Dupilumab (SAR231893) | DRUG | Injection solution Subcutaneous |
Inclusion Criteria: Participants are eligible to be included in the study only if all of the following criteria apply (at screening and baseline unless otherwise specified): * Participant must be at least 18 years of age or the legal age of consent in the jurisdiction in which the study is taking ...