Efficacy of a house dust mite sublingual immunotherapy tablet as add-on dupilumab in asthma with rhinitis
Background: HDM SLIT is one of the disease-modifying treatment for allergic asthma, and has demonstrated efficacy in clinical trials. Dupilumab, blocks IL-4 and IL-13 signaling, key drivers of type 2 inflammation, and is approved for patients with uncontrolled, moderate-to-severe asthma. The aim of...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-10-01
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| Series: | Allergology International |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S132389302200051X |
| _version_ | 1828111610806272000 |
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| author | Makoto Hoshino Kenta Akitsu Kengo Kubota Junichi Ohtawa |
| author_facet | Makoto Hoshino Kenta Akitsu Kengo Kubota Junichi Ohtawa |
| author_sort | Makoto Hoshino |
| collection | DOAJ |
| description | Background: HDM SLIT is one of the disease-modifying treatment for allergic asthma, and has demonstrated efficacy in clinical trials. Dupilumab, blocks IL-4 and IL-13 signaling, key drivers of type 2 inflammation, and is approved for patients with uncontrolled, moderate-to-severe asthma. The aim of this study was to evaluate outcomes after HDM SLIT initiation in asthma with rhinitis not optimally controlled with dupilumab in a real-world setting. Methods: At baseline and 48 weeks after treatment, asthma control questionnaire (ACQ)-5, asthma quality of life questionnaire (AQLQ) and rhinoconjunctivitis quality of life questionnaire (RQLQ) were assessed. Spirometry, type 2 inflammatory biomarkers and quantitative computed tomographic parameters of airway remodeling were also collected. Results: Of 47 patients received HDM SLIT and 41 completed the study. Combined HDM SLIT and dupilumab improved ACQ-5 (p < 0.05), AQLQ (p < 0.05), RQLQ (p < 0.05), and increased lung function and reduced FeNO (p < 0.05) and airway percentage wall area, and wall thickness (each, p < 0.05). The change in ACQ-5 and AQLQ score correlated with both changes in FeNO and FEV1 percent predicted. Multiple regression analysis showed that the change in FEV1 percent predicted was independent factor for improvement of AQLQ (r2 = 0.510, p = 0.012). Based on ROC analysis for predicting SLIT responders, the baseline area under the curves in serum HDM specific-IgE, total IgE and FEV1 percent predicted were high (>0.8). Conclusions: These results support the benefits of adding HDM SLIT to pharmacotherapy plus dupilumab in uncontrolled asthma with rhinitis. |
| first_indexed | 2024-04-11T11:37:11Z |
| format | Article |
| id | doaj.art-d63b27fc38a54d279996a6fb64bdd059 |
| institution | Directory Open Access Journal |
| issn | 1323-8930 |
| language | English |
| last_indexed | 2024-04-11T11:37:11Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Allergology International |
| spelling | doaj.art-d63b27fc38a54d279996a6fb64bdd0592022-12-22T04:25:55ZengElsevierAllergology International1323-89302022-10-01714490497Efficacy of a house dust mite sublingual immunotherapy tablet as add-on dupilumab in asthma with rhinitisMakoto Hoshino0Kenta Akitsu1Kengo Kubota2Junichi Ohtawa3Division of Clinical Allergy, Department of Internal Medicine, Atami Hospital, International University of Health and Welfare, Atami, Japan; Corresponding author. Division of Clinical Allergy, Department of Internal Medicine, Atami Hospital, International University of Health and Welfare, 13-1 Higashi-kaigan-cho, Atami, Shizuoka, Japan.Department of Radiology, Atami Hospital, International University of Health and Welfare, Atami, JapanDepartment of Radiology, Atami Hospital, International University of Health and Welfare, Atami, JapanDepartment of Radiology, Atami Hospital, International University of Health and Welfare, Atami, JapanBackground: HDM SLIT is one of the disease-modifying treatment for allergic asthma, and has demonstrated efficacy in clinical trials. Dupilumab, blocks IL-4 and IL-13 signaling, key drivers of type 2 inflammation, and is approved for patients with uncontrolled, moderate-to-severe asthma. The aim of this study was to evaluate outcomes after HDM SLIT initiation in asthma with rhinitis not optimally controlled with dupilumab in a real-world setting. Methods: At baseline and 48 weeks after treatment, asthma control questionnaire (ACQ)-5, asthma quality of life questionnaire (AQLQ) and rhinoconjunctivitis quality of life questionnaire (RQLQ) were assessed. Spirometry, type 2 inflammatory biomarkers and quantitative computed tomographic parameters of airway remodeling were also collected. Results: Of 47 patients received HDM SLIT and 41 completed the study. Combined HDM SLIT and dupilumab improved ACQ-5 (p < 0.05), AQLQ (p < 0.05), RQLQ (p < 0.05), and increased lung function and reduced FeNO (p < 0.05) and airway percentage wall area, and wall thickness (each, p < 0.05). The change in ACQ-5 and AQLQ score correlated with both changes in FeNO and FEV1 percent predicted. Multiple regression analysis showed that the change in FEV1 percent predicted was independent factor for improvement of AQLQ (r2 = 0.510, p = 0.012). Based on ROC analysis for predicting SLIT responders, the baseline area under the curves in serum HDM specific-IgE, total IgE and FEV1 percent predicted were high (>0.8). Conclusions: These results support the benefits of adding HDM SLIT to pharmacotherapy plus dupilumab in uncontrolled asthma with rhinitis.http://www.sciencedirect.com/science/article/pii/S132389302200051XAsthmaDupilumabHDM-SLITInflammationRemodeling |
| spellingShingle | Makoto Hoshino Kenta Akitsu Kengo Kubota Junichi Ohtawa Efficacy of a house dust mite sublingual immunotherapy tablet as add-on dupilumab in asthma with rhinitis Allergology International Asthma Dupilumab HDM-SLIT Inflammation Remodeling |
| title | Efficacy of a house dust mite sublingual immunotherapy tablet as add-on dupilumab in asthma with rhinitis |
| title_full | Efficacy of a house dust mite sublingual immunotherapy tablet as add-on dupilumab in asthma with rhinitis |
| title_fullStr | Efficacy of a house dust mite sublingual immunotherapy tablet as add-on dupilumab in asthma with rhinitis |
| title_full_unstemmed | Efficacy of a house dust mite sublingual immunotherapy tablet as add-on dupilumab in asthma with rhinitis |
| title_short | Efficacy of a house dust mite sublingual immunotherapy tablet as add-on dupilumab in asthma with rhinitis |
| title_sort | efficacy of a house dust mite sublingual immunotherapy tablet as add on dupilumab in asthma with rhinitis |
| topic | Asthma Dupilumab HDM-SLIT Inflammation Remodeling |
| url | http://www.sciencedirect.com/science/article/pii/S132389302200051X |
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