Efectivity of dupilumab in patients with severa astma in real clinical practice using EXACTO score

<bold>Introduction:</bold> Dupilumab has shown efficacy in asthma in randomized clinical trials1-4. As real-world evidence data with dupilumab is limited to date 5-10, there is a need to extend this knowledge to allow a deeper analysis of the response to this drug in real life. <bold>Methods:</bold> Effectivity was assessed by measuring annualized exacerbation rate (AER), asthma control test (ACT), use of oral corticosteroids (OCS), and pre-bronchodilator forced expiratory volume in the first second (pre-BD FEV1) scores at baseline visit, and at follow up weeks 16 (V1) and 52 (V2). We have performed an effectivity assessment with the EXACTO Score tool11. <bold>Results:</bold> We present a series of 137 severe asthma patients from 18 Spanish reference hospitals treated with dupilumab, between April 2022 and September 2023. At V1, AER reduced from 2.18 at baseline to 0.29 (86.7%), ACT improved from 12.4 to 18.2, FEV1 raised from 69.8% to 88.1%, and OCS cycles diminished from 2.12 to 0.27. At V1, EXACTO scores were calculated (n=119), and 17.6%/37.8%/40.3%/4.2% showed complete/good/partial/no response, respectively. At V2, AER was 0.37, ACT scored 16.8, FEV1 counted 75.1% and OCS cycles were 0.37. At this endpoint (week 52) EXACTO scored 26,3%/29,8%/38,6%/5,3% complete/good/partial/no response, respectively. OCS were prescribed to XX patients at baseline, being necessary in XX cases at week 52. Safety profile was favorable. <bold>Discussion:</bold> We found dupilumab safe and effective in severe asthma patients, as 55.4% of the patients obtained perfect or good early response (16 week visit) as assessed by EXACTO, and 56,1% achieved complete or good response at 12-months follow-up visit.