Dupilumab reduces acute exacerbations and improves lung function in patients with COPD with type 2 inflammation irrespective of body mass index, airflow obstruction, dyspnea, and exercise capacity index scores - 24/04/25
, Klaus F. Rabe b, Surya P. Bhatt c, Nicola A. Hanania d, Mona Bafadhel e, Stephanie A. Christenson f, Alberto Papi g, Dave Singh h, Elizabeth Laws k, Jennifer Maloney j, Paula Dakin j, Xin Lu i, Deborah Bauer i, Ashish Bansal j, Lacey B. Robinson k, Raolat M. Abdulai kAbstract |
Background |
The body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index predicts 5-year mortality risk in chronic obstructive pulmonary disease (COPD); higher scores predict worse outcomes. Dupilumab, a fully human monoclonal antibody that blocks the shared receptor component for interleukin-4/13, reduced exacerbations and improved lung function in patients with COPD in the phase 3 BOREAS trial (NCT03930732). We assessed dupilumab efficacy in patients with COPD and type 2 inflammation by baseline BODE index.
Methods |
Patients with COPD, moderate-to-severe airflow limitation, screening blood eosinophils ≥300 cells/μL, and high exacerbation risk, on triple therapy, received 300 mg add-on dupilumab or placebo every 2 weeks for 52 weeks. Annualized moderate or severe COPD exacerbation rate and change from baseline in pre-bronchodilator forced expiratory volume in 1 s (FEV1) at Weeks 12 and 52 were assessed by baseline BODE index, categorized as low (≤4) or high (>4).
Results |
Of 934 patients with reported baseline BODE index scores (dupilumab: 470; placebo: 464), 61.8 % had scores ≤4. Dupilumab reduced exacerbations versus placebo, regardless of baseline BODE index group. Exacerbation reductions were similar by BODE index group; relative risk (95 % confidence interval) for patients with BODE index >4 versus ≤4 was 0.656 (0.496–0.868) versus 0.718 (0.547–0.944). At Weeks 12 and 52, dupilumab consistently improved pre-bronchodilator FEV1 versus placebo, regardless of baseline BODE index group.
Conclusion |
Dupilumab reduced exacerbations and improved lung function in patients with COPD and type 2 inflammation irrespective of baseline BODE index score.
Clinical trial registration number |
BOREAS trial NCT03930732.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | High BODE index scores predict morbidity and mortality in patients with COPD. |
• | This post hoc analysis of BOREAS assessed dupilumab efficacy by baseline BODE score. |
• | Dupilumab improved COPD exacerbations and lung function across baseline BODE scores. |
Keywords : BODE index, COPD, Dupilumab, Exacerbations, Lung function, Type 2 inflammation
Plan
Vol 241
Article 108015- mai 2025 Retour au numéro
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