The National Institute for Health and Care Excellence (NICE) has issued a Final Appraisal Determination (FAD) recommending Dupixent® (dupilumab), as an add-on maintenance treatment for severe asthma.[1*]
The NICE FAD is based on a subset of patients taking part in the LIBERTY ASTHMA QUEST clinical trial.
Dupilumab acts on the type 2 immune response which is believed to be a major driver in severe asthma. Dupilumab is different to many existing treatments as it works by dampening down two key drivers of the inflammatory process – interlukin-4 and interlukin-13. In severe asthma patients with type 2 inflammation it has been shown, to reduce severe asthma attacks by up to 67% compared to placebo, and hospitalisations/A&E visits by nearly 50% compared to placebo.
In addition to reducing asthma attacks and hospitalisations/A&E visits, in clinical trials, dupilumab also improved lung function (FEV1) in patients with type 2 inflammation by up to 250mls compared to placebo. Furthermore, dupilumab eliminated the need to use oral corticosteroids in 52% (51 patients) of OCS-dependent patients with type 2 inflammation (compared to 29% (27 patients) with placebo).
Professor Ian Pavord, Professor of Respiratory Medicine, Respiratory Medicine Unit and Oxford Respiratory NIHR BRC, Nuffield Department of Medicine, University of Oxford said: “Living with severe, uncontrolled asthma results is a constant struggle with shortness of breath and wheezing, making it very hard to lead a normal life. It can be life threatening when medications are unable to keep asthma under control and severe asthma attacks are too often a reality. Providing patients with new treatment options is particularly important during the ongoing pandemic as people with severe asthma feel especially vulnerable. Biologic treatments, such as dupilumab, which target one of the dominant underlying causes of severe asthma, can transform outcomes for people with severe asthma.”
 NICE, (2021). Final Appraisal Determination. Dupilumab for treating severe asthma with type 2 inflammation. Available at: [insert link]. Last accessed: MONTH 2021.
 Mukherjee M, Stoddart A, Gupta RP. et al. The epidemiology, healthcare and societal burden and costs of asthma in the UK and its member nations: analyses of standalone and linked national databases. BMC Med 14, 113 (2016). https://doi.org/10.1186/s12916-016-0657-8
 Asthma UK, (2018). Slipping through the net: The reality facing patients with difficult and severe asthma. Available at: https://www.asthma.org.uk/6fc29048/globalassets/get-involved/external-affairs-campaigns/publications/severe-asthma-report/auk-severe-asthma-gh-final.pdf. Last accessed: October 2021.