Dupilumab lowers symptom burden in COPD, type 2 inflammation

Key takeaways:

• The phase 3 BOREAS trial included adults with moderate/severe COPD and type 2 inflammation on background triple therapy.
• Receiving 300 mg of dupilumab every 2 weeks helped with respiratory symptom burden.

At 52 weeks, adults with moderate/severe COPD and type 2 inflammation receiving dupilumab vs. placebo showed more improved symptom scores, according to a poster presented at the European Respiratory Society International Congress.

“These results further validate what we have already seen in the BOREAS trial: dupilumab significantly improved respiratory symptom frequency and severity (as measured by E-RS:COPD) compared to placebo,” Alberto Papi, MD, PhD, professor of respiratory medicine at the University of Ferrara in Italy, told Healio.

“The results from this study show that, in addition to overall improvement in the E-RS:COPD, dupilumab also improved specific symptoms as measured by the three domains of this scale: breathlessness, chest symptoms, and cough and sputum,” Papi continued.

Using data from the multicenter, randomized, double-blind, placebo-controlled, parallel-group phase 3 BOREAS study, Papi and colleagues assessed 939 adults (mean age, 65.1 years; 66% men; 84.1% white) with moderate or severe COPD and type 2 inflammation on background triple therapy to see how Evaluating Respiratory Symptoms in COPD (E-RS:COPD) total and domain scores differ between those receiving dupilumab (Dupixent; Regeneron, Sanofi) vs. placebo at 52 weeks.

Of the total cohort, 468 patients received 300 mg of dupilumab every 2 weeks, and 471 patients received placebo every 2 weeks.

As Healio previously reported, the BOREAS study found that adults with moderate/severe COPD and type 2 inflammation receiving dupilumab had a lower exacerbation rate and better lung function at 52 weeks vs. placebo.

Between baseline and week 52, patients receiving dupilumab showed more improvement in total daily symptom burden than patients receiving placebo. Researchers observed a significant least squares mean difference of –1.137 (95% CI, –1.823 to –0.45; P = .0012) in E-RS:COPD total score between the groups.

The dupilumab group also had more improvement in each of the three domains within the E-RS:COPD total score vs. the placebo group over the 52-week period, according to researchers.

The least squares mean difference between those receiving dupilumab vs. placebo was –0.652 (95% CI, –1.018 to –0.286; nominal P = .0005) in E-RS:COPD breathlessness scores, –0.268 (95% CI, –0.487 to –0.048; nominal P = .0171) in E-RS:COPD chest symptoms scores and –0.229 (95% CI, –0.417 to –0.041; nominal P = .017) in E-RS: COPD cough and sputum scores.

“E-RS:COPD is a patient-reported outcome measure, so understanding how dupilumab can impact a patient’s quality of life as it relates to symptoms experienced is important,” Papi told Healio. “In this case, dupilumab led to reductions in multiple key disease symptoms compared to placebo, demonstrating it has the potential to meaningfully impact a patient’s own experience with the disease, for those who are eligible for treatment.

“As dupilumab is approved for the treatment of COPD in countries around the world, future studies can assess how dupilumab works in real-world settings and in diverse populations,” Papi said.