Dupilumab pharmacokinetics and effect on type 2 biomarkers in children with moderate-to-severe asthma

Daniel J Jackson, Leonard B Bacharier, Wanda Phipatanakul, Lawrence Sher, Cristian Domingo Ribas, Nikolaos G. Papadopoulos, Brian Modena, Ning Li, Kamal Changming, Mohamed A. Mohamed, Myles Dillon, Kelley Wolfe, Rebecca Gall, Nikhil Amin, Leda P Mannent, Elizabeth Laws, Paul J Rowe, Juby A Jacob-Nara, Juby A Jacob-Nara, Yamo DenizDavid J Lederer, Megan Hardin, Christine Xu

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)


Background: Type 2 inflammation is common in children with asthma. Dupilumab, a human antibody, blocks the signaling of interleukin -4 and -13, key and central drivers of type 2 inflammation. In the LIBERTY ASTHMA VOYAGE (NCT02948959) study, dupilumab reduced severe asthma exacerbations and improved lung function in children aged 6 to 11 years with uncontrolled, moderate-to-severe asthma.Objective: To assess the pharmacokinetics of dupilumab and type 2 biomarker changes in children with type 2 asthma in VOYAGE.Methods: Patients were randomized to dupilumab 100 mg (<= 30 kg) or 200 mg (>30 kg) or placebo every 2 weeks for 52 weeks. Dupilumab concentrations and changes in type 2 biomarkers were assessed at each visit.Results: Dupilumab concentrations in serum reached a steady state by week 12, with mean concentrations of 51.2 mg/L and 79.4 mg/L in children receiving dupilumab 100 mg every 2 weeks and 200 mg every 2 weeks, respectively (therapeutic range in adults and adolescents: 29-80 mg/L). Reductions in type 2 biomarkers were comparable between regimens, and greater in patients treated with dupilumab vs placebo. In children treated with dupilumab 100 mg and 200 mg every 2 weeks, the median percent changes (Q1 -Q3) from baseline at week 52 were, respectively, -78.6% (-86.3 to -69.80) and -78.6% (-84.9 to -70.1) for serum total immunoglobulin E, -53.6% (-66.4 to -34.6) and -43.7% (-58.6 to -28.5) for thymus and activation-regulated chemokine; -25.7% (-60.0 to 27.6) and 33.3% (-60.6 to 16.6) for blood eosinophils, and -47.7% (-73.8 to 18.9) and -55.6% (-73.6 to -20.0) for fractional exhaled nitric oxide.Conclusion: Weight-tiered dose regimens achieved mean concentrations within the dupilumab therapeutic range. The median decreases in type 2 biomarker levels were similar between dose regimens.
Original languageEnglish
Pages (from-to)44-51.e4
JournalAnnals of Allergy, Asthma and Immunology
Issue number1
Publication statusPublished - Jul 2023


  • Asthma
  • Children
  • Dupilumab
  • Eosinophils
  • FeNO
  • Immunoglobulin E
  • Inflammation
  • Pharmacodynamics
  • Pharmacokinetics
  • Type 2 biomarker


Dive into the research topics of 'Dupilumab pharmacokinetics and effect on type 2 biomarkers in children with moderate-to-severe asthma'. Together they form a unique fingerprint.

Cite this