Dupilumab responder types and predicting factors in patients with type 2 severe asthma: a real-world observational study

<bold>Background:</bold> Severe asthma (SA) remains a considerable healthcare challenge despite optimal standard treatment. Dupilumab, which is effective in type 2 SA patients, shows variable responses, categorizing patients as non-responders, partial responders, or those achieving clinical remission. However, real-world responder rates in SA patients on dupilumab remain underexplored. Additionally, understanding the characteristics of patients achieving remission is crucial for predicting favourable responses to dupilumab. <bold>Objective:</bold> To investigate response types and identify predictors of response induced by dupilumab in a real-world cohort of SA patients. <bold>Methods:</bold> Retrospective study of data from SA patients undergoing dupilumab treatment. Data were collected at baseline and 12 months follow up (T=12). Responder rates were assessed at T=12. Predictors of response were investigated using forward stepwise logistic regression. <bold>Results:</bold> Among the 175 patients screened, 136 met the inclusion criteria. At T=12, 31.6% achieved clinical remission, 21.5% were non-responders and 48.5% were partial responders. Predictors of clinical remission included elevated eosinophil counts and male gender. Conversely, predictors of non-response encompassed younger age, lower IgE and lower FeNO levels. <bold>Conclusions:</bold> Dupilumab response varies in SA patients, resulting in distinct responder types. Remission is predicted by elevated eosinophil levels and male gender, whereas lower IgE and FeNO levels and younger age indicate a lower likelihood of response. Prospective studies are crucial for improving our understanding of responder rates and predictors, which can ultimately guide treatment decisions.