Original Title: Dupilumab en asma grave no controlada

Authors' recommendations: Moderate quality evidence suggests that adding dupilumab to the standard of care versus standard of care with placebo in patients with uncontrolled severe asthma may produce a higher net benefit by reducing acute exacerbations, the use of corticosteroids, improving lung function and controlling asthma symptoms. Additionally, no evidence indicating its adverse effects have led to treatment discontinuation has been observed. It is key to mention that these results are more evident in cases of eosinophilic asthma ≥300μL. Low quality evidence suggests that adding dupilumab to the standard of care versus benralizumab, omalizumab, or mepolizumab added to standard care in patients with severe uncontrolled asthma might produce a marginal net benefit, as it would reduce exacerbations and present a slight improvement in lung function. Asthma management clinical practice guidelines recommend including dupilumab to treat severe or Type 2 eosinophilic asthma, as well as in patients requiring maintenance with oral corticosteroids. In addition to the standard criteria for severe asthma, eligibility criteria usually include a specific number of severe exacerbations in the previous year and specific levels of Type 2 biomarkers (e.g., blood eosinophils ≥150μL and ≤1500μL; or FeNO >25 ppb) and the requirement for maintenance with oral corticosteroids. In terms of coverage policies, most high-income countries cover dupilumab for the treatment of uncontrolled severe asthma, except for public health funders from the United States of America. In Latin America, Brazil has been found to provide coverage of this technology. From the economic point of view, one cost-effectiveness study carried out in Colombia indicates that dupilumab 200 mg was cost-effective when compared with other treatments with biologics, except for omalizumab 300 mg. However, in Argentina, it is uncertain as no cost-effectiveness studies or local budget impact analysis have been found.

Project Status: Completed

Year Published: 2024

URL for published report: https://ets.iecs.org.ar/publication/2180

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Argentina

Organisation Name: Institute for Clinical Effectiveness and Health Policy

Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA

Contact Name: info@iecs.org.ar

Contact Email: info@iecs.org.ar

Copyright: <p>Institute for Clinical Effectiveness and Health Policy (IECS)</p>