Allergy & Immunology

Dupilumab shows the most favorable airway comorbidity profile among systemic AD agents

This Bayesian network meta-analysis included 26 atopic dermatitis RCTs (13,069 participants) comparing biologics and JAK inhibitors against placebo for airway adverse events. Versus nemolizumab 90 mg, dupilumab 300 mg and tralokinumab 150 mg were associated with significantly lower reported asthma risk. SUCRA rankings suggested tralokinumab 150 mg had the lowest asthma-related adverse-event signal, while ISB 830 600 mg ranked highest. For allergic rhinitis, dupilumab 200 mg had the lowest adverse-event incidence, whereas abrocitinib 100 mg had the highest. Cluster analysis identified dupilumab 200 mg as having the lowest combined asthma and rhinitis risk signal among evaluated regimens. Dose–patient confounding and surrogate endpoints limit dose-specific recommendations and require confirmation in airway-focused RCTs. 1

GLP-1 receptor agonists linked to fewer asthma exacerbations in obese adolescents

This cohort study examined glucagonlike peptide-1 receptor agonist use and acute asthma exacerbations in adolescents with overweight or obesity and asthma. GLP-1 receptor agonist exposure was associated with fewer acute exacerbations (RR 0.75, 95% CI 0.62–0.90) compared with nonuse. The magnitude suggests clinically relevant risk reduction complementary to metabolic benefits in this high-risk population. Unmeasured confounding and heterogeneity among specific GLP-1 agents limit causal inference but support pulmonary considerations when choosing obesity therapies. 2

Oral SYK inhibitor BI 894416 is safe and biologically active in early-phase asthma studies

Single- and multiple-rising-dose randomized, placebo-controlled trials evaluated oral BI 894416 in 56 healthy volunteers and 68 patients with mild asthma. BI 894416 was generally well tolerated; headache, diarrhea, and nausea were the most frequent drug-related adverse events, all mild or moderate. No serious adverse events occurred, and pharmacokinetics showed rapid absorption with dose-dependent exposure across the tested range. Basophils and nasal epithelial cells demonstrated dose-dependent modulation of activation and disease-associated gene pathways. These target-engagement data support SYK inhibition as a mechanistically plausible strategy for future asthma efficacy trials. 3