Identifying predictive baseline characteristics for super response to dupilumab in patients with severe uncontrolled asthma.

Dupilumab is an IgG4 human monoclonal antibody which acts upon the type 2 inflammatory pathway. It has been shown to have a significant impact on patients with severe asthma through reducing exacerbations and improving symptom control. A subgroup of patients experiences excellent symptom control and elimination of exacerbations within 12 months of starting dupilumab and are termed super responders. Here we retrospectively identify real-life patients on dupilumab at a single centre to review the baseline characterises comparing those who achieve super response against those that do not. 48 patients were included with 23 fulfilling criteria for super response. Significant differences were seen between the mean (95%CI) baseline eosinophils (343cells/µL (9, 677) p < 0.05) and FeNO (32.18ppb (0.88, 63.48) p < 0.05). Additionally, super-response was found to be associated with nasal polyps (chi squared -5.88, p < 0.05). In conclusion, super response to dupilumab in patients with severe asthma was associated with raised eosinophils and FeNO along side the presence of nasal polyps.