Dupilumab is a monoclonal antibody blocking the alpha subunit of IL-4 and IL-13. This mechanism reduces type 2 inflammation, exacerbations and improves lung function in patients with moderate to severe asthma. The VESTIGE study is a multicentre randomised, double-blind, placebo-controlled, phase 4 trial assessing the effect of dupilumab on airway structure and remodelling with functional respiratory imaging. Dupilumab reduces airway inflammation and mucus plugs and improves airway volumes and flow, which leads to an improvement in lung function and asthma control in patients with moderate to severe asthma.