Overview
Mild persistent allergic asthma uncontrolled refers to a condition where asthma symptoms persist daily or near-daily, are triggered by allergens, and are not adequately managed with standard therapies 1. This often involves ongoing symptoms despite treatment, impacting quality of life and lung function 1.Diagnosis
Type 2 asthma is characterized by blood eosinophils ≥150 cells/μL or fractional exhaled nitric oxide (FeNO) ≥20 ppb 1.Management
Dupilumab as an add-on therapy demonstrated efficacy in children aged 6 to 11 years with uncontrolled moderate to severe type 2 asthma 1.
Dupilumab reduced severe exacerbation rates by 63% in children receiving high-dose inhaled corticosteroids (ICS) and 59% in those receiving medium-dose ICS 1.
Dupilumab improved percent predicted FEV1 at 52 weeks in children with uncontrolled moderate to severe type 2 asthma 1.
The efficacy of dupilumab was observed regardless of the ICS dose at baseline 1.Special Populations
Pediatrics: Dupilumab showed clinical efficacy and an acceptable safety profile in children aged 6 to 11 years with uncontrolled moderate to severe type 2 asthma 1.Key Recommendations
Consider dupilumab as an add-on therapy for children aged 6 to 11 years with uncontrolled moderate to severe type 2 asthma, particularly those with blood eosinophils ≥150 cells/μL or FeNO ≥20 ppb 1. (Evidence: Strong)
Dupilumab can reduce severe asthma exacerbation rates in children with uncontrolled moderate to severe type 2 asthma, irrespective of their baseline inhaled corticosteroid (ICS) dose 1. (Evidence: Strong)
Dupilumab may improve lung function (percent predicted FEV1) in children with uncontrolled moderate to severe type 2 asthma 1. (Evidence: Strong)References
1 Maspero JF, Antila MA, Deschildre A, Bacharier LB, Altincatal A, Laws E et al.. Dupilumab Efficacy in Children With Type 2 Asthma Receiving High- to Medium-Dose Inhaled Corticosteroids (VOYAGE). The journal of allergy and clinical immunology. In practice 2024. link