• Surya P Bhatt, Klaus F Rabe, Nicola A Hanania, Claus F Vogelmeier, Mona Bafadhel, Stephanie A Christenson, Alberto Papi, Dave Singh, Elizabeth Laws, Paula Dakin, Jennifer Maloney, Xin Lu, Deborah Bauer, Ashish Bansal, Raolat M Abdulai, and Lacey B Robinson.
• Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL. Electronic address: sbhatt@uabmc.edu.
• Chest. 2025 Jan 31.

BackgroundPatient-reported outcomes should be considered alongside clinical assessments to guide therapy for chronic obstructive pulmonary disease (COPD).Research QuestionDoes add-on dupilumab treatment improve health-related quality of life and respiratory symptoms in patients with COPD and type 2 inflammation?Study Design And MethodsIn this pooled analysis of two phase 3 trials, patients with COPD and type 2 inflammation on triple therapy were randomized 1:1 to dupilumab 300 mg (n = 938) or placebo (n = 936) every 2 weeks for 52 weeks. Quality of life and respiratory symptom severity were measured by change from baseline to Week 52 in St. George's Respiratory Questionnaire (SGRQ; total [0-100 units, lower scores indicating better quality of life] and domain scores for symptoms, activity, and impacts) and Evaluating Respiratory Symptoms in COPD (E-RS:COPD; total [0-40 units, lower scores meaning less severe respiratory symptoms] and domain scores for breathlessness, cough and sputum, and chest symptoms).ResultsIn total, 1,660 patients reached Week 52 (n = 830 in each treatment arm). At Week 52, dupilumab vs placebo reduced SGRQ and E-RS:COPD total scores by least squares mean differences (95% CI) of -3.4 (-5.0, -1. 8; P < .0001) vs -0.9 (-1.4, -0.4; P = .0006). Similar reductions were observed across SGRQ domain scores of symptoms (-3.5 [-5.5, -1.5]), activity (-4.0 [-5.9, -2.1]), and impacts (-2.9 [-4.6, -1.1]), and E-RS:COPD domain scores of breathlessness (-0.6 [-0.8, -0.3]), cough and sputum (-0.2 [-0.3, 0.0]), and chest symptoms (-0.1 [-0.3, 0.0]).InterpretationDupilumab demonstrated improvements in SGRQ and E-RS:COPD total and domain scores in patients with COPD and type 2 inflammation.Copyright © 2025. Published by Elsevier Inc.

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