{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T13:47:49Z","timestamp":1793368069525,"version":"4.5.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":87,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004339","name":"Sanofi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004339","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Regeneron Pharmaceuticals Inc."}],"content-domain":{"domain":["www.atsjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Chronic mucus hypersecretion contributes to airway obstruction in asthma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess dupilumab efficacy by baseline mucus plug score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In VESTIGE (NCT04400318), adults with moderate-to-severe asthma, baseline blood eosinophils\u2009\u2265300 cells\/\u03bcL, and fractional exhaled nitric oxide (FeNO)\u2009\u226525\u2009ppb received dupilumab 300\u2009mg (n\u2009=\u200972) or placebo (n\u2009=\u200937) every 2\u2009weeks for 24\u2009weeks. Post hoc analyses included mucus plug score change from baseline, and patient proportion achieving FeNO &amp;lt;25\u2009ppb, percent predicted FEV1, and FVC stratified by baseline mucus plug score (high\/low defined by score\u2009\u22654 or 0-3.5, respectively, derived from high-resolution computed tomography scans).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Fewer dupilumab-receiving patients had high mucus plug score at week 24 than at baseline (32.8% vs 67.2%); proportions remained similar in placebo-receiving patients (76.7% vs 73.3%). Dupilumab versus placebo recipients were more likely to achieve FeNO &amp;lt;25\u2009ppb in high-\/low-mucus-plug score subgroups (odds ratio, 6.64; P\u2009=\u2009.003\/8.54; P\u2009=\u2009.024). Dupilumab versus placebo significantly increased pre-\/post-bronchodilator percent predicted FEV1 (least squares mean difference [LSMD], 16.77 percentage points [95% CI, 9.81-23.73]; P\u2009&amp;lt;.0001 [pre] and 12.70 [95% CI, 3.87-21.52]; P\u2009=\u2009.0055 [post]) and pre-bronchodilator FVC (LSMD, 0.42\u2009mL [95% CI, 0.17-0.66]; P\u2009=\u2009.001), and numerically improved post-bronchodilator FVC (LSMD, 0.30\u2009mL [95% CI, 0.01-0.59]; P\u2009=\u2009.0399) in the high-mucus-plug score subgroup.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dupilumab reduced mucus plug scores and improved lung function in patients with moderate-to-severe asthma with high baseline mucus plug score, and increased the likelihood of achieving FeNO &amp;lt;25\u2009ppb regardless of baseline mucus plug score.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.202410-1894oc","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T04:00:21Z","timestamp":1761624021000},"page":"241-252","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":18,"title":["Effect of dupilumab on mucus burden in patients with moderate-to-severe asthma: the VESTIGE trial"],"prefix":"10.1093","volume":"212","author":[{"given":"Celeste","family":"Porsbjerg","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine and Infectious Diseases, Bispebjerg and Frederiksberg Hospital , Copenhagen,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor M","family":"Dunican","sequence":"additional","affiliation":[{"name":"Education and Research Centre, St Vincent\u2019s Hospital Elm Park , Dublin,","place":["Ireland"]},{"name":"Department of Medicine, School of Medicine, University College Dublin , Dublin,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Njira L","family":"Lugogo","sequence":"additional","affiliation":[{"name":"Michigan Medicine Asthma Program, University of Michigan , Ann Arbor, MI,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Castro","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Kansas School of Medicine , Kansas City, KS,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Papi","sequence":"additional","affiliation":[{"name":"Department of Cardiorespiratory Medicine, Respiratory Unit, University of Ferrara, S. 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