Abstract：
BACKGROUND: Severe asthma (SA) presents a considerable healthcare challenge despite optimal standard treatment. Dupilumab, which is effective in type 2 (T2) SA patients, demonstrates variable responses, categorizing patients as non-responders, partial responders, or those achieving clinical remission. However, real-world response rates remain underexplored. Additionally, understanding the characteristics of patients achieving clinical remission is crucial for predicting favourable responses to dupilumab.
OBJECTIVE: To investigate responder types and identify predictors of clinical remission and non-response induced by dupilumab in a real-world cohort of SA patients.
METHODS: We analyzed retrospective data from SA patients undergoing dupilumab treatment in a study conducted at Franciscus Gasthuis & Vlietland hospital. Data were collected at baseline and at a 12 to 24-months follow-up (T = 12). Response rates were evaluated at T = 12. Predictors of non-response and clinical remission were investigated using multivariate logistic regression analysis with a stepwise forward variable selection approach.
RESULTS: Among the 175 patients screened, 136 met the inclusion criteria. At T = 12, 31.6 % achieved clinical remission, 47.1 % were partial responders and 21.3 % were non-responders. Predictors associated with clinical remission included high baseline blood eosinophil counts (BEC) and male sex. Conversely, younger age at baseline, low baseline total immunoglobin E (IgE) and low baseline fractional exhaled nitric oxide (FeNO) levels were identified as predictors of non-response.
CONCLUSIONS: Dupilumab results in clinical disease remission in one-third of the treated patients. Clinical remission is predicted by high BEC and male sex, whereas low total IgE, low FeNO and younger age indicate a lower likelihood of response.
OBJECTIVE: To investigate responder types and identify predictors of clinical remission and non-response induced by dupilumab in a real-world cohort of SA patients.
METHODS: We analyzed retrospective data from SA patients undergoing dupilumab treatment in a study conducted at Franciscus Gasthuis & Vlietland hospital. Data were collected at baseline and at a 12 to 24-months follow-up (T = 12). Response rates were evaluated at T = 12. Predictors of non-response and clinical remission were investigated using multivariate logistic regression analysis with a stepwise forward variable selection approach.
RESULTS: Among the 175 patients screened, 136 met the inclusion criteria. At T = 12, 31.6 % achieved clinical remission, 47.1 % were partial responders and 21.3 % were non-responders. Predictors associated with clinical remission included high baseline blood eosinophil counts (BEC) and male sex. Conversely, younger age at baseline, low baseline total immunoglobin E (IgE) and low baseline fractional exhaled nitric oxide (FeNO) levels were identified as predictors of non-response.
CONCLUSIONS: Dupilumab results in clinical disease remission in one-third of the treated patients. Clinical remission is predicted by high BEC and male sex, whereas low total IgE, low FeNO and younger age indicate a lower likelihood of response.
摘要：
背景：尽管最佳的标准治疗，严重哮喘（SA）仍存在相当大的医疗保健挑战。Dupilumab,对2型（T2）SA患者有效，演示变量响应，将患者归类为无应答者，部分响应者，或那些实现临床缓解的人。然而,现实世界的反应率仍然不足。此外,了解获得临床缓解的患者的特征对于预测dupilumab的有利反应至关重要.
目的：在真实世界的SA患者队列中，调查应答者类型并确定dupilumab诱导的临床缓解和无反应的预测因子。
方法：我们分析了在FranciscusGathuis&Vlietland医院进行的一项研究中接受dupilumab治疗的SA患者的回顾性数据。在基线和12至24个月随访时收集数据（T=12）。在T=12时评估反应率。使用多变量逻辑回归分析和逐步前向变量选择方法研究了无反应和临床缓解的预测因素。
结果：在筛查的175名患者中，136符合纳入标准。T=12时，31.6%达到临床缓解，47.1％为部分反应者，21.3％为无反应者。与临床缓解相关的预测因素包括高基线血嗜酸性粒细胞计数(BEC)和男性。相反，基线时年龄较小，低基线总免疫球蛋白E(IgE)水平和低基线呼出气一氧化氮(FeNO)水平被确定为无应答的预测因子.
结论：Dupilumab在1/3的治疗患者中导致临床疾病缓解。高BEC和男性预测临床缓解，而总IgE低，低FeNO和年龄较小表明反应的可能性较低。
目的：在真实世界的SA患者队列中，调查应答者类型并确定dupilumab诱导的临床缓解和无反应的预测因子。
方法：我们分析了在FranciscusGathuis&Vlietland医院进行的一项研究中接受dupilumab治疗的SA患者的回顾性数据。在基线和12至24个月随访时收集数据（T=12）。在T=12时评估反应率。使用多变量逻辑回归分析和逐步前向变量选择方法研究了无反应和临床缓解的预测因素。
结果：在筛查的175名患者中，136符合纳入标准。T=12时，31.6%达到临床缓解，47.1％为部分反应者，21.3％为无反应者。与临床缓解相关的预测因素包括高基线血嗜酸性粒细胞计数(BEC)和男性。相反，基线时年龄较小，低基线总免疫球蛋白E(IgE)水平和低基线呼出气一氧化氮(FeNO)水平被确定为无应答的预测因子.
结论：Dupilumab在1/3的治疗患者中导致临床疾病缓解。高BEC和男性预测临床缓解，而总IgE低，低FeNO和年龄较小表明反应的可能性较低。
