Dupilumab Plus Medium-Dose Inhaled Corticosteroid ICS Improves Outcomes Compared With Placebo Plus Continued HighDose ICS in Children With Uncontrolled ModeratetoSevere Type 2 Asthma

A 9-year-old boy with moderate-to-severe type 2 asthma characterized by a baseline blood eosinophil count of 200 cells/μL and FeNO of 25 ppb has been on high-dose inhaled corticosteroids (ICS) for the past year but continues to experience frequent severe exacerbations requiring oral corticosteroids. He has no known drug allergies and is otherwise healthy. His current medications include fluticasone propionate 500 mcg twice daily and albuterol as needed. The pediatric pulmonologist is considering initiating dupilumab therapy and adjusting his ICS regimen.

Based on the VOYAGE study findings, what is the most appropriate pharmacotherapy adjustment for this patient to improve asthma control and reduce exacerbations?

An 8-year-old girl with moderate asthma is being evaluated for biologic therapy due to poor symptom control despite medium-dose ICS and a long-acting beta-agonist. Her lab results show a blood eosinophil count of 140 cells/μL and FeNO of 18 ppb. She has no history of severe exacerbations and is adherent to her current regimen. The clinical pharmacist is asked to advise on the appropriateness of dupilumab initiation.

According to the study and related biomarker analyses, which statement best describes the suitability of dupilumab therapy for this patient?

A 10-year-old boy with uncontrolled moderate-to-severe type 2 asthma started dupilumab plus medium-dose ICS 3 months ago. His baseline pre-bronchodilator ppFEV1 was 65%, and his ACQ-7-IA score was 2.5. At his follow-up visit, the pharmacist reviews his spirometry results and symptom scores to assess treatment response.

Which of the following clinical improvements would align with the expected outcomes reported in the VOYAGE study after 52 weeks of dupilumab plus medium-dose ICS therapy?