D3.420 - Real-world epidemiologic characteristics of patients treated with dupilumab for type 2 inflammatory indications: a single-center retrospective cohort study

Type 2 (T2) inflammation, driven by interleukin (IL)-4 and IL-13 signaling, underlies multiple allergic and inflammatory diseases, including bronchial asthma, chronic rhinosinusitis with nasal polyps (CRSwNP), eosinophilic esophagitis (EoE), and atopic dermatitis (AD). Dupilumab, a fully human monoclonal antibody targeting the IL-4 receptor alpha subunit, has demonstrated efficacy across these conditions. However, comparative real-world epidemiologic data describing patient characteristics and indication distribution across the T2 disease spectrum remain limited.

We conducted a retrospective cohort study of adult patients treated with dupilumab at a tertiary referral center between October 2019 and October 2024. Patients were identified from institutional electronic medical records and categorized by primary indication: asthma, CRSwNP, EoE, AD, and other T2 inflammatory diseases.

From an initial 766 patients, exclusions were applied for non-receipt of dupilumab, follow-up duration <3 months, advanced chronic lung diseases, end-stage renal or liver disease, non–T2-driven conditions, and alternative diagnoses not meeting indication-specific criteria (e.g., esophageal abnormalities other than EoE or non-atopic skin diseases). The final validated cohort included 658 patients. Baseline demographics and indication distribution were analyzed descriptively. Longitudinal effectiveness and safety outcomes are currently under analysis and will be reported separately.

After validation, 658 of 766 patients were included in the final analysis. The mean age was 42.7 ± 14.4 years, with 50.2% female patients.

The most common indication for dupilumab therapy was CRSwNP (n = 250), followed by asthma (n = 209) and atopic dermatitis (n = 113). Eosinophilic esophagitis accounted for 26 patients, while other T2 inflammatory conditions (n = 60) included prurigo nodularis, chronic pruritus, hypereosinophilic syndromes, and other rare T2 phenotypes. This analysis focuses on baseline epidemiologic characteristics and indication distribution among dupilumab-treated patients.

In this large real-world cohort, dupilumab was prescribed across a broad spectrum of T2 inflammatory diseases, reflecting substantial heterogeneity and multisystem involvement. These epidemiologic data provide a robust foundation for future analyses evaluating long-term effectiveness and safety outcomes across T2 indications.