Older patients on dupilumab for asthma, chronic rhinosinusitis see more adverse events

Key takeaways:

• Patients ranged in age from 65 to 90 years with a mean of 71.8 years.
• 29.1% of the patients experienced an adverse event while on dupilumab.
• 43.75% of the patients with adverse events discontinued treatment.

BOSTON — Patients aged 65 years and older on dupilumab for asthma and chronic rhinosinusitis experienced greater risks for adverse events than younger patients, according to a poster presented at the CHEST Annual Meeting.

However, the lack of serious adverse events suggests that these patients should continue with this therapy, Timothy Crisci, MD, a third-year pulmonary and critical care fellow at Thomas Jefferson University, and colleagues wrote.

The study comprised 55 patients (mean age, 71.8 years; 58% women) aged 65 to 90 years who began treatment with dupilumab (Dupixent; Regeneron, Sanofi) for asthma or chronic rhinosinusitis between March 2019 and November 2023.

The cohort included 17 patients (30.9%) who had asthma, 13 patients (23.6%) patients with chronic rhinosinusitis and 25 patients (45.5%) with both.

Also, 26 patients (47.3%) had never smoked, 24 patients (43.6%) were former smokers three (5.4%) were current smokers, and two patients did not report smoking status.

There were 16 patients (29.1%) who experienced an adverse event during therapy, including six patients (11%) with a dermatologic concern, two patients (4%) with musculoskeletal concerns, five patients (9%) with ophthalmologic complications and four patients with other adverse events.

Seven of the patients who experienced adverse events, representing 43.75% of those who experienced adverse events and 13% of the full cohort, discontinued therapy.

There were no cases of anaphylaxis, severe infections, death or other serious adverse events. Also, the researchers said there were no statistical differences in age between those who did and did not experience an adverse event, nor were there any differences based on gender.

The researchers noted that these rates of adverse events coincided with rates reported in previous studies of geriatric patients who were on dupilumab for atopic dermatitis, although they added that their study had a higher discontinuation rate among those patients who experienced adverse events.

Yet based on these findings, the researchers concluded that patients aged 65 years and older are more likely to experience adverse events of any type or severity with treatment than younger patients.

Considering the lack of serious events, the researchers also said that these patients should continue with dupilumab, although they advised clinicians to mind higher rates of minor adverse events when discussing starting treatment with patients.

The researchers additionally called for further studies to better understand the effectiveness of dupilumab among patients in this age group so clinicians and patients can be better informed about its risks and benefits before beginning treatment.