Welcome Dupixent!

When new anti-asthma biologics come to the door, always give them a welcome seat. Here is an anti- atopic dermatitis monoclonal antibody that also shuts down a key component of the allergy airway inflammation pathway, now a 12 and up asthma therapy.  Dr. Susarla

Dive Brief:

• Sanofi and Regneron have won an expanded U.S. approval for Dupixent in asthma, securing another indication for the biologic drug which the companies are counting on to deliver blockbuster sales. 
• On Friday, the Food and Drug Administration OK'd the drug for moderate-to-severe asthma patients with an eosinophilic phenotype, or with oral corticosteroid-dependent asthma regardless of phenotype, the companies said. The new indication adds to Dupixent's previously approved use for moderate-to-severe atopic dermatitis.
• Clinical results supporting the approval showed Dupixent cut severe asthma attacks by 67% compared to placebo in patients with high eosinophil counts. Among patients with lower levels of the inflammation marker, however, Dupixent did not separate from placebo in statistical comparison. 

Read article here.

Digital Devices for Insomnia? Researchers say YES

Cognitive behavioral therapy is an intervention the incorporates coping strategies and behavioral modifications to treat a variety of conditions including insomnia.  When done properly it has been shown to be as effective as pharmacotherapy. Dr. Susarla

Digitally delivered cognitive-behavioral therapy not only improved insomnia, but also provided “around-the-clock” health, psychological, and quality-of-life improvements, according to investigators.

Compared with control subjects, patients who used a cognitive-behavioral therapy (CBT) program and associated iPhone app had small improvements in functional health and psychological well-being and large improvements in sleep-related quality of life, the investigators reported.

Those changes were mediated by a large improvement in insomnia, according to Colin A. Espie, PhD, professor of sleep medicine at the University of Oxford (England), and his colleagues.

“These findings indicate that digital CBT improves both daytime and nighttime aspects of insomnia, lending further weight to the clinical guideline recommendation of CBT as the treatment of choice for insomnia,” Dr. Espie and his colleagues reported in JAMA Psychiatry.

Their study included 1,711 adults with symptoms of insomnia that were self-reported and a score of 16 or less on the Sleep Condition Indicator (SCI), which has a range of 0-32. A total of 853 were randomized to receive digital CBT, of whom 413 completed six scheduled 20-minute sessions; an additional 276 adults completed at least one session. The control arm included 858 individuals randomized to sleep hygiene education, of whom 759 went on to receive that intervention.

Read article here.

10 Treatable Traits That Could Predict Asthma Attacks

The science and art of predicting asthma risk may go beyond asthma symptoms and lung physiology and intersect with the presence of chronic disease. Dr. Susarla

With increasing attention on a “treatable traits”—a new classification and precision medicine strategy for asthma and other chronic airway diseases,1 a team of researchers set out to examine whether and which treatable traits could be identified from registry data in persons with severe asthma and used to predict the future risk of asthma exacerbations.2

In their study, published in the journal Respirology, the investigators recorded the prevalence of the treatable asthma traits of 434 participants with severe asthma and 102 participants with non-severe asthma, all of whom were enrolled in the Australasian Severe Asthma Web‐Based Database. The prevalence of participants’ treatable asthma traits were described. They assessed participants at the study’s outset and then every 6 months thereafter for 24 months.

Of the 24 treatable traits the researchers identified, 10 predicted exacerbation risk in the participants with severe asthma, with the 5 strongest as follows:

• Being prone to exacerbations
• Depression
• Inhaler device polypharmacy
• Vocal cord dysfunction
• Obstructive sleep apnea

“Treatable traits can be assessed using a severe asthma registry,” the authors concluded. “In severe asthma, patients express more treatable traits than non‐severe asthma. Traits may be associated with future asthma exacerbation risk demonstrating the clinical utility of assessing treatable traits.”

Read article here.