Effect of Dupilumab Treatment on Blood Eosinophil Levels in Patients With Asthma, Chronic Rhinosinusitis With Nasal Polyps (CRSwNP), Eosinophilic Esophagitis (EoE), or Atopic Dermatitis (AD)

Dupilumab blocks the shared receptor component of IL-4/IL-13, key and central drivers type 2 inflammation. In patients with asthma or CRSwNP, a transient increase in eosinophils was observed dupilumab treatment which declined over time rarely clinical consequence. The effect on blood assessed across indications. Median (95% CI) percent change from baseline measured dupilumab-treated uncontrolled moderate-to-severe (QUEST [NCT02414854]: N=1,902; TRAVERSE [NCT02134028] dupilumab/dupilumab-arm: N=1,013), severe CRSwNP (SINUS-52 [NCT02898454]: N=303; EoE [NCT02379052]: N=47), AD (CHRONOS [NCT02260986]: N=425) patients. asthma, increased by 9.2% ([4.3–14.3]; P=0.001) at Week 4, returned to 24, fell below 52 (−12.3% [−15.9 −7.7]; P=0.03). This trend sustained 96 for treated who continued open-label TRAVERSE. 16.2% ([–5.9 34.0]; P=0.26) rise seen 16 resolved 24. No period AD. Hypereosinophilia (>3,000cells/μL) rare, few discontinued due eosinophilia (QUEST: 7 discontinued/52 cases, TRAVERSE: 2/3, SINUS-52: 1/2), majority did not require corrective treatment. Rare cases EGPA eosinophilic pneumonia were reported; causal association has been established. Transient early elevation generally levels time. Eosinophils