Atopic Dermatitis Biologic Has Treatment Impact on Asthma

New research indicates that a medication traditionally used to treat adults with moderate to severe atopic dermatitis (AD) may be effective in treating asthma.1,2 This is especially relevant to people for whom eczema or other forms of AD lead to asthma.

The atopic dermatitis-asthma connection has been a topic of medical interest and scientific research since the 1920’s. Health population statistics estimate more than 31 million people in the United States have some form of AD and nearly 25 million have asthma.2

Dupixent (dupilumab)

Dupilumab is an anti-inflammatory drug used to treat atopic dermatitis, sold under the brand name Dupixent. It is an anti-interleukin-4/-13 drug, a biologic agent that is administered by subcutaneous injection. Duplilumab comes as a single-dose pre-filled syringe with needle shield. It can be used with or without topical corticosteroids.

Approved by the FDA in 2017, Dupixent is currently being reviewed for a new indication, seeking approval as a treatment for moderate to severe uncontrolled asthma. Significant study results indicate lower exacerbation rates, improved lung function and better control of asthma.

Clinical trial updates

Two double-blind, randomized clinical trials, QUEST and VENTURE, set out to investigate whether treatment with dupilumab could improve lung function in a safer, more effective way for people with moderate-to-severe uncontrolled asthma. The study population of QUEST included those who require the use of multiple inhalers with different medicines to control their asthma. In the VENTURE study participants used the same inhalers but also took oral steroid medications.1

Study specifics

Both QUEST and VENTURE studies found that dupilumab reduced symptoms and helped patients to breathe more easily. The demonstrated improvements were measured by an increase in the volume of air that a person could exhale.

Study results found that dupilumab improved asthma control, and contributed to fewer flare-ups, with increased lung function compared to those treated with placebos. Dosage variability in the studies did not influence the outcome.2 Participants in the VENTURE study who were users of oral steroids found that they were able to eliminate or dramatically reduce steroid use by virtue of their duplilumab treatments.1,2

Treatment goals were achieved, and study participants experienced fewer sick days and trips to the ER for asthma-related reasons. This is important because some people find themselves unable to work due to severe uncontrolled asthma.

Treatment costs

According to Dr. Sally Wenzel from the University of Pittsburgh, dupilumab has the potential to be a “game changer.” Yet prohibitive costs may make patient access difficult. Each shot costs $3,000, or $36,000 {sic} per year. Therefore finding the right patients are essential, those who would most benefit from the therapy.1

What is the atopic march?

Atopic refers to a hypersensitive allergic reaction such as dermatitis or asthma that can affect a part of the body not in contact with the allergen. March means to advance or progress. Atopic march is a phenomenon that describes the progression of allergic conditions that can develop early in life. It can also describe when children of parents with asthma develop eczema and then progress to asthma. It appears to be both a genetic and environmental association, with no fixed order of progression. Allergies can include forms of atopic dermatitis, food allergies, allergic rhinitis and asthma.

Research on atopic march continues to examine the link between age of onset, severity and persistence of allergic conditions. It is most often associated with the development of eczema as early as 6 months old. The earlier the development of allergic conditions, the more likely people are to suffer from multiple allergies.

Allergic conditions can be debilitating for some, so severe that they can keep people out of school or work. Medications such as dupilumab show promise in offering treatments that can significantly improve quality of life.

Atopic dermatitis is more than just skin symptoms. Share what it is like for you living with atopic dermatitis and the complications that often accompany it. Take our survey here.

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