| Title: |
Exploring Definitions and Predictors of Severe Asthma Clinical Remission Post-Biologic in Adults. |
| Authors: |
Perez-de-Llano, L; Scelo, G; Tran, TN; Le, TT; Faregås, M; Cosio, BG; Peters, M; Pfeffer, PE; Al-Ahmad, M; Al-Lehebi, RO; Altraja, A; Bergeron, C; Bjermer, LH; Bjerrum, AS; Bulathsinhala, L; Busby, J; Cano Rosales, DJ; Canonica, GW; Carter, VA; Charriot, J; Christoff, GC; Denton, EJ; Dorscheid, DR; Fernandez Sanchez, MJ; Fonseca, JA; Gibson, PG; Goh, CYY; Heaney, LG; Heffler, E; Hew, M; Iwanaga, T; Katial, R; Koh, MS; Kuna, P; Larenas-Linnemann, DES; Lehtimäki, L; Mahboub, B; Martin, N; Matsumoto, H; Menzies-Gow, AN; Papadopoulos, NG; Popov, TA; Porsbjerg, CM; Patel, P; Rhee, CK; Sadatsafavi, M; Taillé, C; Torres-Duque, CA; Tsai, M-J; Ulrik, CS; Upham, JW; von Bülow, A; Wang, E; Wechsler, ME; Price, DB |
| Publisher Information: |
American Thoracic Society |
| Publication Year: |
2024 |
| Collection: |
Queen Mary University of London: Queen Mary Research Online (QMRO) |
| Subject Terms: |
anti-IL4Rα; anti-IL5/5R; anti-IgE; exacerbation; lung function |
| Description: |
RATIONALE: There is no consensus on criteria to include in an asthma remission definition in real-life. Factors associated with achieving remission post-biologic-initiation remain poorly understood. OBJECTIVES: To quantify the proportion of adults with severe asthma achieving multi-domain-defined remission post-biologic-initiation and identify pre-biologic characteristics associated with achieving remission which may be used to predict it. METHODS: This was a longitudinal cohort study using data from 23 countries from the International Severe Asthma Registry. Four asthma outcome domains were assessed in the 1-year pre- and post-biologic-initiation. A priori-defined remission cut-offs were: 0 exacerbations/year, no long-term oral corticosteroid (LTOCS), partly/well-controlled asthma, and percent predicted forced expiratory volume in one second ≥80%. Remission was defined using 2 (exacerbations + LTOCS), 3 (+control or +lung function) and 4 of these domains. The association between pre-biologic characteristics and post-biologic remission was assessed by multivariable analysis. MEASUREMENTS AND MAIN RESULTS: 50.2%, 33.5%, 25.8% and 20.3% of patients met criteria for 2, 3 (+control), 3 (+lung function) and 4-domain-remission, respectively. The odds of achieving 4-domain remission decreased by 15% for every additional 10-years asthma duration (odds ratio: 0.85; 95% CI: 0.73, 1.00). The odds of remission increased in those with fewer exacerbations/year, lower LTOCS daily dose, better control and better lung function pre-biologic-initiation. CONCLUSIONS: One in 5 patients achieved 4-domain remission within 1-year of biologic-initiation. Patients with less severe impairment and shorter asthma duration at initiation had a greater chance of achieving remission post-biologic, indicating that biologic treatment should not be delayed if remission is the goal. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
Am J Respir Crit Care Med; https://qmro.qmul.ac.uk/xmlui/handle/123456789/96731 |
| DOI: |
10.1164/rccm.202311-2192OC |
| Availability: |
https://qmro.qmul.ac.uk/xmlui/handle/123456789/96731; https://doi.org/10.1164/rccm.202311-2192OC |
| Rights: |
This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/). For commercial usage and reprints please contact Diane Gern (dgern@thoracic.org). |
| Accession Number: |
edsbas.C4C5C1D2 |
| Database: |
BASE |