Ep. 134: How Dupilumab Reduces Mucus Burden in Asthma - VESTIGE Trial
Part of the series: The Itch Review
LISTEN TO EPISODE 134: Apple Podcast • Spotify •Amazon Music
This podcast was made in partnership with Allergy & Asthma Network. A special collaboration with the American Thoracic Society.
Mucus plugging is a challenge in asthma care. It’s thick, sticky mucus that blocks the airways and doesn’t respond to regular inhalers. Even when inflammation improves, these plugs can lower lung function, limit how well medicine works, and make asthma harder to control.
In this episode, we break down the study: “Effect of Dupilumab on Mucus Burden in Patients with Moderate-to-Severe Asthma,” published October 28, 2025. The analysis looks at whether dupilumab (Dupixent), a biologic that blocks IL-4 and IL-13, can lower mucus burden and improve lung function, especially in people who start with a high “mucus plug score.”
What we cover in our episode about dupilumab and mucus plugging:
Why mucus plugging matters in asthma: Discover how thick, sticky mucus can block airways, make it harder to breathe, and why standard inhalers and steroids don’t clear these plugs.
How dupilumab may help: Learn how this biologic blocks IL-4 and IL-13, two key drivers of type 2 inflammation that increase mucus production and thickness.
Inside the VESTIGE study: Hear how researchers measured mucus burden using CT scans and “mucus plug scores” to see if dupilumab could reduce plugging in moderate-to-severe asthma.
What the results showed: Find out how dupilumab lowered mucus plug scores, reduced airway inflammation, and improved lung function (FEV₁), especially in people with high mucus burden.
What this means for patients: Learn why identifying and treating mucus plugging may help improve breathing, reduce flare-ups, and make asthma easier to manage day to day.
More resources about asthma and dupilumab
What is asthma?
What is type 2 inflammation?
When Asthma Is More Than Just Asthma: Type 2 Inflammation
More about dupilumab (Dupixent)
Watch more episodes about asthma and dupilumab
The Itch Review, hosted by Dr. Gupta, Kortney, and Dr. Blaiss, explores allergy and immunology studies, breaking down complex research in conversations accessible to clinicians, patients, and caregivers. Each episode provides key insights from journal articles and includes a one-page infographic in the show notes for easy reference.
Timestamps
Our episode discusses the diagnosis and treatment of mast cell disease in the yardstick from 2025
01:21 What is mucus and mucus plugging
05:42 Asthma basics
09:42 Mucus in the lungs
10:57 How dupilumab works
14:11 VESTIGE trial design
17:48 Who qualified for the study
22:53 Patients in the study
25:46 Study endpoints
28:10 Study results
33:53 Study limitations
36:06 Key takeaways
