Dupixent Study

Question 1

___ % of Americans have asthma representing ___ Americans… ___ adults… ___ children

Answer 1

8.3%
26.5 million (20.4 adults, 6.1 children)

Question 2

The estimated economic cost of asthma is $___ billion annually.

Answer 2

$56 billion

Question 3

Asthma is a _____ inflammation of the ____ airways that causes coughing, chest tightness, wheezing or shortness of breath.

Answer 3

chronic
lung

Question 4

Dupilimab is a human monoclonal antibody in the ______ subclass

Answer 4

igG4

Question 5

Dupilimab inhibits ___ and ___ __________ by binding to the _____________________

Answer 5

IL4 and IL13 signalling
IL-4 receptor alpha subunit

Question 6

Dupilimab blocks the shared ____ component of both __ and __ receptors

Answer 6

Il-4Rα
IL-4 and IL-13

Question 7

Type 2 inflammation involves ________ cells and _______________.

Answer 7

T-helper 2 cells (Th2)
Group 2 Innate Lymphoid Cells (ILC2)

Question 8

____ cells and ________ produce key cytokines like IL-4, IL-5 and IL-13.

Answer 8

Th2 cells and ILC2

Question 9

Th2 cells

Answer 9

T Helper 2 Cells

Question 10

ILC2

Answer 10

Group 2 Innate Lymphoid Cells

Question 11

IL-5 is crucial for….

Answer 11

eosinophilic development and survival

Question 12

IL-4, IL-13 and IL-5 are involved in….

Answer 12

eosinophilic trafficking to tissues

Question 13

Type 2 Inflammation leads to these symptoms and conditions…

Answer 13

• nasal polyps
• loss of smell
• nasal obstruction in CRSwNP
• impaired lung function
• wheezing
• shortness of breath
• chest tightness
• coughing in asthma

Question 14

Key and central cytokines for type 2 airway diseases include ___ and ____, creating a cyclical effects by upregulating differentiation of ___ and ___ cells

Answer 14

IL 4 and IL 13
Th0 and Th2

Question 15

In asthma, IL-13 affects ____ and airway smooth _______
________, impacting mucus _________, smooth muscle __________, and basement _________ _____________

Answer 15

goblet and airway smooth muscle cells
Mucus secretion
contractibility
membrane thickening

Question 16

IL-13 facilitates a_______ o__________ by tethering to ______-producing cells, impairing __________ transport

Answer 16

airway obstruction
mucus
mucociliary

Question 17

IL-13 upregulates ________________ production in asthma

Answer 17

nitric oxide

Question 18

FeNO

Answer 18

fractional exhaled nitric oxide
FeNO levels of < 25 of parts per billion (ppb) is considered normal, 25 ppb - 50 ppb as intermediate, and > 50 ppb high

Question 19

CRSwNP

Answer 19

Chronic Rhinosinusitis with Nasal Polyps

Question 20

GINA

Answer 20

Global Initiative for Asthma

Question 21

GINA2021 guidelines outline a stepwise approach from r______ medications to ____ controllers and __________ therapies based on disease severity

Answer 21

reliever
dual
biologic

Question 22

ICS examples

Answer 22

inhaled corticosteroid
Fluticasone (Flonase, Flovent): Available in various formulations, including Flonase nasal spray for allergic rhinitis and Flovent inhalers for asthma.
Budesonide (Pulmicort): Commonly used for asthma and available as an inhaler or nebulizer solution.
Beclomethasone (Qvar): Another ICS used for the management of asthma.
Mometasone (Asmanex): Available as an inhaler for asthma.
Ciclesonide (Alvesco): An inhaled corticosteroid used for asthma treatment.

Question 23

ICS-formoterol

Answer 23

Symbicort
ICS + LABA (formoterol)

Question 24

LABA + example

Answer 24

long acting beta2 agonist
salmaterol
advair - fluticasone/salmeterol)
Serevent (salmeterol as a standalone LABA)

Question 25

ICS-LABA action

Answer 25

The ICS component helps reduce inflammation in the airways, while the LABA component works as a bronchodilator, helping to relax and widen the airways.

Question 26

LAMA + example

Answer 26

Long-Acting Muscarinic Antagonist
Spiriva (tiotropium) / Turdoza
LAMAs work by blocking the action of acetylcholine, a neurotransmitter that plays a role in regulating the contraction of smooth muscles in the airways. By blocking the effects of acetylcholine, LAMAs help to relax and widen the airways, making it easier for individuals with respiratory conditions to breathe.

Question 27

SABA + example

Answer 27

short acting beta2 agonist
albuterol
These are medications commonly used for the quick relief of acute bronchoconstriction or broncho-spasm in conditions such as asthma and chronic obstructive pulmonary disease (COPD). SABAs work by stimulating the beta2-adrenergic receptors in the smooth muscles of the airways, leading to bronchodilation.

Question 28

LTRA + example

Answer 28

leukotriene receptor antagonists
Singulair Montelukast
These drugs work by blocking the action of leukotrienes, which are inflammatory mediators involved in the immune response.

Question 29

ICS-LABA

Answer 29

This term refers to a combination medication that includes both an inhaled corticosteroid (ICS) and a long-acting beta2-agonist (LABA). These combination inhalers are commonly used in the management of asthma and chronic obstructive pulmonary disease (COPD).
Fluticasone/Salmeterol (Advair): This combination includes the corticosteroid fluticasone and the LABA salmeterol.
Budesonide/Formoterol (Symbicort): This combination includes the corticosteroid budesonide and the LABA formoterol.
Mometasone/Formoterol (Dulera): This combination includes the corticosteroid mometasone and the LABA formoterol.

Question 30

Anti-IGE

Answer 30

Anti-IgE refers to a class of medications that target immunoglobulin E (IgE), an antibody involved in the allergic response. These medications are specifically designed to reduce the levels of IgE in the body, thereby modulating the allergic response.
Omalizumab (Xolair): This monoclonal antibody binds to circulating IgE antibodies, preventing them from attaching to cells and triggering allergic reactions. Omalizumab is primarily used in the treatment of moderate to severe allergic asthma and chronic idiopathic urticaria (chronic hives).

Question 31

Anti IL-5

Answer 31

Anti-IL-5 medications are a class of drugs that target interleukin-5 (IL-5), a cytokine involved in the regulation of eosinophils, a type of white blood cell. These medications are primarily used in the treatment of severe eosinophilic asthma and certain eosinophilic conditions. They help reduce the number and activity of eosinophils, which are often elevated in allergic and eosinophilic disorders.
Mepolizumab (Nucala): This monoclonal antibody targets IL-5 and is used to treat severe eosinophilic asthma and eosinophilic granulomatosis with polyangiitis (EGPA).
Reslizumab (Cinqair): Another IL-5 inhibitor, reslizumab is indicated for the treatment of severe eosinophilic asthma.
Benralizumab (Fasenra): This medication targets the IL-5 receptor and is used to treat severe eosinophilic asthma. It works by depleting eosinophils and reducing asthma exacerbations.

Question 32

HDM SLIT

Answer 32

House Dust Mite Sublingual Immunotherapy. It is a form of immunotherapy used in the treatment of allergic conditions, particularly those related to house dust mite (HDM) allergies.

Question 33

Six approved biological therapies for asthma and other type inflammatory diseases

Answer 33

omalizumab (anti-IgE) - Xolair
mepolizumab (anti-IL-5) - Nucala
reslizumab (anti–IL-5) - Cinqair
benralizumab (anti-IL-5Rα) - Fasenra
dupilumab (anti-IL-4Rα) - Dupixent
tezepelumab (anti-TSLP) - Tezspire
each targeting specific cytokines in the type 2 inflammatory cascade.

Question 34

TSLP

Answer 34

Thymic stromal lymphopoietin (TSLP) is a key epithelial cytokine that sits at the top of the inflammatory cascade and acts as an alarm for the immune system.