PP-081 Dupilumab reduces systemic corticosteroids in children with uncontrolled moderate-to-severe asthma
Bibliographic record
Abstract
Aim To assess the impact of dupilumab on severe exacerbations, systemic corticosteroid (SCS) use, and lung function in children with moderate-to-severe asthma.Material and Method In VOYAGE ( NCT02948959), children aged 6–11 years with uncontrolled moderate-to-severe type 2 inflammatory asthma were randomized 1:2 to placebo or dupilumab for 52 weeks. Children could then receive dupilumab for 52 weeks in EXCURSION (NCT03560466). We report annualized severe exacerbation event rates, annualized SCS courses, and changes from baseline in percentage of predicted pre-bronchodilator forced expiratory volume in 1 second (ppFEV1) among children who completed VOYAGE and entered EXCURSION, stratified by exacerbation history (1 or ≥2) in the year before VOYAGE.Results 43 placebo and 77 dupilumab recipients had 1 exacerbation in the year before VOYAGE, while 63 placebo and 132 dupilumab recipients had ≥2. During VOYAGE, annualized severe exacerbation event rates with placebo and dupilumab were 0.46 vs 0.14 and 0.84 vs 0.48 among those with 1 or ≥2 prior exacerbations/year, respectively. During EXCURSION, they were 0.09 vs 0.09 and 0.20 vs 0.18, respectively, for placebo/dupilumab vs dupilumab/dupilumab. SCS use was higher with placebo vs dupilumab in VOYAGE (annualized courses 0.49 vs 0.16 and 0.97 vs 0.55 among those with 1 or ≥2 prior exacerbations/year, respectively), but similar for placebo/dupilumab vs dupilumab/dupilumab during EXCURSION (0.12 vs 0.09 and 0.27 vs 0.23, respectively). Mean (SD) changes from baseline in ppFEV1 (%) at Week 52 in VOYAGE were 3.0 (12.1) vs 10.6 (15.9) and 4.4 (15.4) vs 13.8 (20.1) among those with 1 or ≥2 prior exacerbations/year, respectively; at Week 52 in EXCURSION they were 2.5 (14.3) vs 7.4 (10.0) and 14.4 (18.7) vs 9.6 (14.9), respectively.Conclusions Among children with uncontrolled moderate-to-severe type 2 asthma, dupilumab reduced severe exacerbations and SCS exposure while improving/maintaining lung function for up to 2 years, regardless of exacerbation history.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".