Persistent OCS reduction regardless of starting OCS dose in patients with severe, OCS-dependent asthma treated with dupilumab: LIBERTY ASTHMA TRAVERSE study

Introduction: We assessed dupilumab long-term efficacy in patients with OCSdependent severe asthma and varying baseline OCS doses in TRAVERSE
(NCT02134028).
Materials and Methods: Patients with OCS-dependent asthma received dupilumab 300mg every 2 weeks (q2w) or placebo for 24 weeks during VENTURE
(NCT02134028), followed by dupilumab 300mg q2w for up to 96 weeks in
TRAVERSE (dupilumab/dupilumab [DPL/DPL] and placebo/dupilumab [PBO/DPL]
groups, respectively]. Patients were stratified by VENTURE baseline OCS dose (≤10 or >10 mg/day). OCS dose percentage reduction from VENTURE baseline, prebronchodilator FEV1 at TRAVERSE Weeks 0 and 48, and annualized rate of severe asthma exacerbations (AER) during VENTURE and TRAVERSE were assessed.
Results: 187 patients (≤10 mg/day, PBO/DPL: n=61, DPL/DPL: n=60; >10 mg/day, PBO/DPL: n=36; DPL/DPL: n=30) were analyzed. The greater reductions in daily OCS use observed in patients on dupilumab in VENTURE continued in TRAVERSE in DPL/DPL patients (Figure & Table). Patients initiating dupilumab in TRAVERSE (PBO/DPL) showed further reduction in OCS use, irrespective of OCS dose at baseline (Table). Despite continued reductions in OCS use, AER continued to decline during TRAVERSE, and pre-bronchodilator FEV1 greatly improved (Table). Safety during TRAVERSE was consistent with the known dupilumab safety profile.
Conclusions: Dupilumab reduced OCS dose and improved and maintained clinical efficacy outcomes, regardless of baseline OCS starting dose. Dupilumab
consistently reduced OCS use without a tapering schema of reduction in
TRAVERSE.