Real-world Clinical Outcomes in Asthma Patients Commenced on or Switched to Dupilumab

Introduction Ireland has one of the highest asthma rates globally, with an estimated 450,000 individuals diagnosed. For patients with severe asthma who remain uncontrolled despite optimal therapy, biologics targeting Type 2 inflammation, such as dupilumab, offer a promising treatment option. Dupilumab became available for reimbursement in Ireland in November 2023. We aimed to assess the real-world effectiveness of dupilumab in adults with severe asthma, including those previously treated with other biologics. Methods This retrospective, single-centre study reviewed patients initiated on or switched to dupilumab between November 2023 and November 2024 at Cork University Hospital. Outcomes assessed at baseline and six months included Asthma Control Questionnaire (ACQ) scores, exacerbation frequency, and FEV1. Paired t-tests were used for statistical analysis. Results Among 39 patients (median age 55 years), 64.1% had prior biologic exposure. Dupilumab significantly improved ACQ scores (mean reduction -0.95, p =0.0003) and reduced exacerbations (mean reduction -2.89, p =0.0004). Improvements were consistent in biologic-naïve and biologic-experienced groups. FEV1 showed a non-significant upward trend ( p =0.1553). Five patients (12.8%) discontinued therapy due to side effects or lack of efficacy. Discussion These findings support the real-world effectiveness of dupilumab in improving symptom control and reducing exacerbation frequency in patients with severe asthma, including those who have previously received other biologics. Dupilumab became reimbursable in Ireland in late 2023, and data from Irish populations have been limited until now. Conclusion Dupilumab significantly improved asthma control and reduced exacerbation rates in this real-world cohort, supporting its use in patients with severe asthma, including those switching from other biologic agents.