Real-World Experience With Dupilumab in Severe Asthma: The Spanish Multicenter Study DUPImpact.

BACKGROUND AND OBJECTIVE: Dupilumab has proven effective in asthma in clinical trials, although real-world evidence remains limited. While tools such as FEOS and EXACTO may aid in evaluating effectiveness, evidence supporting their use remains scarce. Objective: To evaluate the real-world effectiveness of dupilumab in a Spanish cohort of patients with uncontrolled severe type 2 (T2) asthma. METHODS: DUPImpact was a retrospective, multicenter study including adults with severe uncontrolled T2 asthma treated with dupilumab in 7 Spanish hospitals. Clinical outcomes were evaluated at 6 and 12 months and included the annual exacerbation rate (AER), asthma control (Asthma Control Test [ACT]), lung function (FEV1), and maintenance oral corticosteroid (OCS) use. Response was quantified using the FEOS and EXACTO scales. RESULTS: The study population comprised 94 patients, of whom most had previously received biologics and 16% were OCS-dependent. After 12 months, AER decreased significantly, asthma control improved for most patients (ACT ≥20), and the mean increase in FEV1 was >300 mL. The number of patients receiving maintenance OCS decreased from 15 to 5, and the mean daily dose tended to decrease (not significant). According to the FEOS and EXACTO scales, over 70% of patients were classified as good responders, with 31% classified as super-responders. CONCLUSIONS: The DUPImpact study confirms the real-world effectiveness of dupilumab in reducing exacerbations and OCS use and improving asthma control and lung function. FEOS and EXACTO enable a multidimensional assessment beyond individual measures.