Dupilumab Reduces Mucus Plug Scores With Moderate-to-Severe Asthma

MONDAY, Nov. 3, 2025 (HealthDay News) — Dupilumab reduces mucus plug scores and improves lung function in patients with moderate-to-severe asthma and high baseline mucus plug scores, according to a study published online Oct. 2 in the American Journal of Respiratory and Critical Care Medicine.

Celeste Porsbjerg, M.D., Ph.D., from Bispebjerg Hospital in Copenhagen, Denmark, and colleagues assessed the efficacy of dupilumab on mucus burden and lung function in adults with moderate-to-severe asthma, baseline blood eosinophils ≥300 cells/µL, and fractional exhaled nitric oxide (FeNO) ≥25 ppb. The analysis included participants receiving dupilumab 300 mg (72 patients) or placebo (37 patients) every two weeks for 24 weeks.

The researchers found that fewer dupilumab-receiving patients had high mucus plug scores at week 24 than at baseline (32.8 versus 67.2 percent), while the proportions remained similar in placebo-receiving patients (76.7 versus 73.3 percent). Patients treated with dupilumab were more likely than those receiving placebo to achieve FeNO <25 ppb in high- versus low-mucus-plug score subgroups (odds ratio, 6.64 versus 8.54). Additionally, compared with placebo, dupilumab significantly increased pre- versus post-bronchodilator percent predicted forced expiratory volume in 1 second (least squares mean difference [LSMD], 16.77 versus 12.70 percentage points) and pre-bronchodilator forced vital capacity (FVC; LSMD, 0.42 mL) and numerically improved post-bronchodilator FVC (LSMD, 0.30 mL) in those with a high mucus plug score.

“Reduced mucus plugging may contribute to the clinically meaningful improvements in global and distal lung function, with more pronounced effects in patients with higher mucus plug score at baseline compared to those with lower scores,” the authors write.

Several authors disclosed ties to pharmaceutical companies, including Sanofi and Regeneron Pharmaceuticals, which manufacture dupilumab and funded the study.

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