The following is a summary of “Dupilumab responder types and predicting factors in patients with type 2 severe asthma: a real-world cohort study,” published in the July 2024 issue of Pulmonology by Bult et al.

Severe asthma (SA) continues to pose a significant healthcare challenge despite the best standard treatments. Dupilumab has shown effectiveness in patients with type 2 (T2) SA, but responses to the treatment vary, resulting in patients being classified as non-responders, partial responders, or those achieving clinical remission. However, real-world response rates to dupilumab still need to be studied more. Identifying the characteristics of patients who achieve clinical remission is essential for predicting favorable responses to dupilumab.

This study aimed to investigate the types of responders to dupilumab and identify clinical remission and non-response predictors in a real-world cohort of patients with SA.

The researchers conducted a retrospective analysis of patients with SA undergoing dupilumab treatment at Franciscus Gasthuis & Vlietland Hospital. Data were collected at baseline and a 12 to 24-month follow-up (T=12). Response rates were assessed at T=12, and non-response and clinical remission predictors were identified using multivariate logistic regression analysis with a stepwise forward variable selection approach.

Of the 175 patients screened, 136 met the inclusion criteria. At T=12, 31.6% of patients achieved clinical remission, 47.1% were partial responders, and 21.3% were non-responders. High baseline blood eosinophil counts (BEC) and male sex were significant predictors of clinical remission. Conversely, younger age at baseline, low baseline total immunoglobulin E (IgE), and low baseline fractional exhaled nitric oxide (FeNO) levels were identified as predictors of non-response.

Dupilumab induces clinical disease remission in approximately one-third of treated patients. High BEC and male sex are strong predictors of clinical remission, while low total IgE, low FeNO, and younger age at baseline indicate a lower likelihood of response. These findings underscore the importance of personalized treatment approaches in managing severe asthma and provide valuable insights into optimizing dupilumab therapy for T2 patients with SA.

Source: sciencedirect.com/science/article/abs/pii/S0954611124001951