Baseline Characteristics of Dupilumab-Treated Patients with Asthma in the Real World: The RAPID Global Registry
Bibliographic record
Abstract
Patients with uncontrolled, moderate-to-severe asthma have a higher risk for exacerbations, negatively impacting lung function and quality of life. Dupilumab, a fully human monoclonal antibody, blocks interleukins 4 and 13, key and central drivers of type 2 inflammation. Dupilumab has been effective in the treatment of certain types of moderate-to-severe asthma across several clinical trials. We describe the characteristics of patients enrolled in RAPID, a global prospective registry, who initiated dupilumab (primary indication: asthma) in a real-world clinical setting. A total of 205 patients (aged ≥ 12 years) were enrolled between March 2020 and October 2021 and are included in this analysis. Data are shown as mean (SD) unless stated otherwise. Patients were aged 50.1 (17.4) years and were mostly female (65.4%) and white (74.1%). At enrollment, 24.4% reported being current/former smokers and 86.8% had moderate-to-severe asthma (Global Initiative for Asthma steps 3–5). A mean (SD) of 4.4 (6.4) severe asthma exacerbations were reported in the year before enrolling in the registry in 78 of 152 patients with available data. Patients had reduced lung function [pre-bronchodilator forced expiratory volume in 1 s (FEV1): 2.3 (1.1) L; pre-bronchodilator percent predicted FEV1: 70.3 (20.3) %] and poor asthma control [6-item Asthma Control Questionnaire: 2.4 (1.2); Asthma Quality of Life Questionnaire: 4.1 (1.3)]. The median (Q1–Q3) blood eosinophil count was 305 (200–695) cells/µL and the mean (SD) fractional exhaled nitric oxide levels were 42 (35) ppb (range: 4–186 ppb). Our findings suggest that most patients who enrolled in RAPID and initiated dupilumab in real-world clinical settings had a high disease burden, despite receiving current standard-of-care treatment at enrollment. Severe asthma can be difficult to control with currently available medicines. Asthma attacks, also called asthma flare-ups or exacerbations, are episodes where symptoms such as coughing, wheezing, shortness of breath, or chest tightness can suddenly occur or worsen, severely affecting quality of life. Dupilumab is a prescription medication used, along with other medicines, to treat asthma. In clinical trials, dupilumab worked well in patients with moderate-to-severe asthma, reducing the number of asthma attacks and improving lung function, characterized by easier breathing. To determine how well dupilumab works outside of a clinical trial setting, we look at studies set in the real world (observational studies). The RAPID registry is an observational study in which adolescents and adults starting dupilumab treatment for asthma are monitored by their doctor. Here, we report information on the first 205 patients who enrolled in the RAPID study between March 2020 and October 2021. At the beginning of the study, doctors diagnosed most patients (87%) with moderate-to-severe asthma. More than half of the patients had at least one severe asthma attack in the previous year but many had more than one (average: 4.4 attacks). Overall, patients had poor lung function, asthma control, and quality of life. Many patients also showed increased levels of markers for type 2 inflammation, an immune response activating cells such as eosinophils, mast cells, and T-cells. Overall, most patients with asthma who started dupilumab in a real-world clinical setting had a high disease burden, despite receiving standard-of-care treatment at the time of enrollment.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| 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 | 0.001 |
| 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) | 0.000 | 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 teacher head, 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".