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    Respiratory

    (410) Baseline Characteristics of Patients on Medium-Versus High-Dose Inhaled Corticosteroids in Patients Initiating Dupilumab in a Real-World Clinical Setting: The RAPID Registry

    Wednesday, October 29, 2025

      Presenter(s)

    • Casey Reed, n/a

      Senior Director, MVO, EV Gen and Ops.
      Population Health Medical Engagement - Medical Value and Outcomes, Genzyme Corporation
      Cambridge, Massachusetts, United States

      • Primary Author(s)

    • Njira L. Lugogo, n/a

      Clinical Professor of Internal Medicine
      University of Michigan, Ann Arbor, MI, USA
      Durham, North Carolina, United States

      • Co-Author(s)

    • Andréanne Côté, n/a

      Researcher
      Quebec Heart and Lung Institute – Laval University, Quebec, QC, Canada
      Québec City, Ontario, Canada

    • Arnaud Bourdin, n/a

      Pulmonologist
      University of Montpellier, PhyMedExp INSERM CNRS, Montpellier, France
      Montpellier, Ile-de-France, France

    • Anju T. Peters, n/a

      Professor of Medicine
      Northwestern University Feinberg School of Medicine, Chicago, IL, USA
      Chicago, Illinois, United States

    • Leonard Bacharier, n/a

      Professor of Pediatrics
      Monroe Carell Jr Children’s Hospital at Vanderbilt University Medical Center, Nashville, TN, USA
      Nashville, Tennessee, United States

    • Changming Xia, Dr.

      Associate Director, Statistics
      Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
      Tarrytown, New York, United States

    • Nami Pandit- Abid, n/a

      US Medical Franchise Head
      Sanofi, Bridgewater, NJ, USA
      New York, New York, United States

    • Juby A. Jacob- Nara, n/a

      Global VP, Medical Head
      Sanofi, Bridgewater, NJ, USA
      Vienna, Vorarlberg, Austria

    • Harry Sacks, n/a

      Oral and Maxillofacial Surgeon
      Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
      New York, New York, United States

    • Paul J. Rowe, MD, ATSF

      VP, Head of Global Medical Immunology
      Sanofi, Cambridge, MA, USA
      Cambridge, Massachusetts, United States

    • Yamo Deniz, MD, FAAAAI

      VP Global Medical Affairs, Head, Immunology Global Medical Franchise
      Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
      Tarrytown, New York, United States

    • Mena Soliman, n/a

      Senior Global Medical Director
      Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
      Tarrytown, New York, United States


    Background:     : Evidence in the literature suggests that inhaled corticosteroid (ICS) dose escalation from a medium to high dose may offer little added benefit (as measured by reductions of exacerbation events, improvements in lung function, or patient-reported outcomes), while increasing the risk of adverse events due to excessive corticosteroid use. Dupilumab, a human monoclonal antibody, blocks interleukins 4 and 13, key and central drivers of type 2 inflammation. RAPID (NCT04287621), a global, prospective registry, aimed to characterize patients with asthma initiating dupilumab in real-world clinical practice

    Objective: : This analysis assessed the effect of medium- vs high-dose ICS at baseline on clinical efficacy and patient-reported outcomes in patients initiating dupilumab in a real-world setting stratified by baseline ICS dose

    Methods: : RAPID enrolled 719 patients (aged ≥12 years) who initiated dupilumab for asthma (primary indication) according to the country-specific prescribing information. The number of severe asthma exacerbations in the year before enrollment, patient-reported outcomes (6-item Asthma Control Questionnaire [ACQ-6], and healthcare resource utilization [HCRU] questionnaire) at baseline were assessed in patients stratified by medium- vs high-dose ICS

    Results: : This analysis included 251 patients on medium-dose ICS and 310 on high-dose ICS at the time of enrollment. In the year before enrollment, 130/224 (58.0%) of patients on medium-dose ICS had severe exacerbation events (mean [SD]: 1.9 [3.4]), and 181/267 (67.8%) of patients on high-dose ICS had a mean of 2.4 (SD: 3.1) severe exacerbation events. Patients on medium-dose (n = 217 [86.5%]) and on high-dose (n = 254 [81.9%]) ICS had a baseline mean (SD) ACQ-6 score of 2.4 (1.2). The mean (SD) number of hospitalizations was 0.1 (0.5) for patients on medium-dose ICS, with 18 (7.2%) patients reporting hospitalization and 49 (19.5%) patients reporting emergency room visits. Patients on high-dose ICS had a mean (SD) number of 0.2 (0.8) hospitalizations, with 37 (11.9%) reporting hospitalization and 58 (18.7%) patients reporting emergency room visits

    Conclusions: : Patients with poorly controlled asthma (according to their ACQ-6 score) who initiated dupilumab in a real-world clinic had a high disease burden and recorded similar healthcare resource utilization, regardless of the ICS dose at baseline

    Sponsorship:: Sanofi and Regeneron Pharmaceuticals, Inc