The main objective of asthma pharmacological management in adults and teenagers is to maintain long-term control of the disease, including symptom relief, the prevention of exacerbations, the improvement of pulmonary function, the reduction of limitations in daily life and side effects of pharmacological treatments.

Dupilumab is a recombinant human monoclonal antibody that inhibits signalling of both IL-4 and IL-13, two Type 2 cytokines involved in inflammatory pathway. Dupixent obtained a European Marketing Authorization in September 2017 and was reimbursed in France from March 5, 2019 in adults with moderate-to-severe atopic dermatitis. On November 10, 2020, the reimbursement of Dupixent was extended to adults and adolescents aged 12 and over as add-on maintenance treatment for severe asthma with type 2 inflammation characterised by raised blood eosinophils (≥ 0.150 g/L) and/or raised fraction of exhaled nitric oxide (FeNO ≥ 20 ppb), who are inadequately controlled with high dose inhaled corticosteroids (ICS) plus another medicinal product for maintenance treatment. Lastly, on July 22, 2021, Dupixent was also reimbursed in patients with severe nasal polyposis.

Primary objective: To describe the characteristics of patients using dupilumab for severe asthma in a real-world setting.

Secondary objectives:

• To describe the Health Care Resource Use (HCRU) and associated costs of severe asthmatic patients using dupilumab.
• To describe the use of corticosteroids (oral and inhaled) before and after dupilumab initiation.
• To study persistence with dupilumab in real-world

Inclusion Criteria:

• At least one reimbursement of dupilumab during the inclusion period from November 10, 2020 to December 31, 2023

• At least one of the following asthma markers:

  • at least one reimbursement of inhaled corticosteroids (ICS and fixed-dose combination ICS/LABA inhalers) in a 3-month time-window before and after one of the reimbursement of dupilumab
  • A Long-Term Disease (LTD) for asthma in the 12 months before dupilumab initiation or over follow-up.
  • An hospital admission for asthma in the 12 months before dupilumab initiation or over follow-up.

Exclusion Criteria:

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For this study, we will use the data from the SNDS database. This is the French claims database, which contains all information related to public and private healthcare reimbursements from various regimens in France. It includes all non-hospital reimbursed healthcare expenditures. In 2019, SNIIRAM covered 98.8% of the French population. It also contains demographic characteristics (age, sex, vital status), information on healthcare professionals, presence of chronic condition with ICD-10 codes, as well as information on date and nature of medical and paramedical interventions, laboratory tests, medical transportations, and number of days of paid sick leaves. These data are linked to the hospital discharge ICD-10 diagnoses codes for all medical, obstetric, and surgery hospitalizations, medical procedures, hospitalization department, and cost coding system. Data are also linked to the national deaths database for medical causes of death.