B32-41 Comparative Study Between Dupilumab and Tezepelumab for Achieving Clinical Remission of Adult Severe Asthma

Abstract Rationale Dupilumab is a monoclonal antibody against interleukin 4/13 receptor. In contrast, tezepelumab is a monoclonal antibody against thymic stromal lymphopoietin, which stimulates both innate and adaptive immunity from upstream. We retrospectively compared dupilumab and tezepelumab in terms of achieving clinical remission of adult severe asthma. Methods Clinical remission was defined by satisfaction of four criteria: no chronic oral corticosteroid use; no asthma exacerbation; asthma control test (ACT) score 23; and percentage predicted forced expiratory volume in 1 second (%FEV1.0) 80% for more than 1 year. We investigated the numbers of patients who did not meet these criteria before and more than 1 year after starting dupilumab or tezepelumab. Results Subjects included 17 patients receiving dupilumab(Group D; 13 men, 4 women; median age, 76 years) and 17 patients receiving tezepelumab (Group T; 6 men, 11 women; median age, 74 years). Median peripheral eosinophil count was 650/mm3 in Group D and 360/mm3 in Group T. Median exhaled nitric oxide concentration was 37 ppb in Group D and 29 ppb in Group T. The number of patients treated with chronic oral corticosteroids had not changed significantly after 1 year of treatment in Group D (from 11.7% to 5.9%) or Group T (from 5.9% to 5.9%). The frequency of asthma exacerbations was significantly reduced after 1 year of treatment in both Group D (p = 0.0133) and Group T (p = 0.0077). The number of patients with ACT score 23 increased significantly after 1 year of treatment in both groups (dupilumab, p = 0.0412; tezepelumab, p = 0.0412). No significant change in %FEV1.0 was seen in either group. The number of patients who achieved clinical remission (meeting all 4 criteria) increased significantly in both Group D (p = 0.0233) and Group T (p = 0.0233). Conclusion Dupilumab and tezepelumab appear similarly efficacious for achieving clinical remission of adult severe asthma, despite their different mechanisms of action. This abstract is funded by: None