| Title: |
Exploring definitions and predictors of response to biologics for severe asthma. |
| Authors: |
Scelo, G; Tran, TN; Le, TT; Faregås, M; Dorscheid, D; Busby, J; Al-Ahmad, M; Al-Lehebi, R; Altraja, A; Beastall, A; Bergeron, C; Bjermer, L; Bjerrum, AS; Cano-Rosales, DJ; Canonica, GW; Carter, V; Charriot, J; Christoff, GC; Cosio, BG; Denton, E; Fernandez-Sanchez, MJ; Fonseca, JA; Gibson, PG; Goh, C; Heaney, LG; Heffler, E; Hew, M; Iwanaga, T; Katial, R; Koh, MS; Kuna, P; Larenas-Linnemann, D; Lehtimäki, L; Mahboub, B; Martin, N; Matsumoto, H; Menzies-Gow, AN; Papadopoulos, NG; Patel, P; Perez-De-Llano, L; Peters, M; Pfeffer, PE; Popov, TA; Porsbjerg, CM; 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: |
Elsevier |
| Publication Year: |
2024 |
| Collection: |
Queen Mary University of London: Queen Mary Research Online (QMRO) |
| Subject Terms: |
anti-IL4Rα; anti-IL5/5R; anti-IgE; control; exacerbation; lung function; oral corticosteroid |
| Description: |
BACKGROUND: Biologic effectiveness is often assessed as 'response', a term which eludes consistent definition. Identifying those most likely to respond in real-life has proven challenging. OBJECTIVE: To explore definitions of biologic responders in adults with severe asthma and investigate patient characteristics associated with biologic response. METHODS: This was a longitudinal cohort study using data from 21 countries, which shared data with the International Severe Asthma Registry. Changes in 4 asthma outcome domains were assessed in the 1-year period pre- and post-biologic-initiation in patients with predefined level of pre-biologic impairment. Responder cut-offs were: ≥50% reduction in exacerbation rate, ≥50% reduction in long-term oral corticosteroid [LTOCS] daily dose, ≥1 category improvement in asthma control, and ≥100mL improvement in FEV1. Responders were defined using single- and multiple-domains. The association between pre-biologic characteristics and post-biologic-initiation response were examined by multivariable analysis. RESULTS: 2,210 patients were included. Responder rate ranged from 80.7% (n=566/701) for exacerbation-response to 10.6% (n=9/85) for 4-domain-response. Many responders still exhibited significant impairment post-biologic-initiation: 46.7% (n=206/441) of asthma control-responders with uncontrolled asthma pre-biologic still had incompletely-controlled disease post-biologic-initiation. Predictors of response were outcome-dependent. Lung function-responders were more likely to have higher pre-biologic FeNO (OR:1.20 for every 25ppb increase), and shorter asthma duration (OR:0.81, for every 10-year increase in duration). Higher BEC and presence of T2-related comorbidities were positively associated with higher odds of meeting LTOCS-, control- and lung function-responder criteria. CONCLUSION: Our findings underscore the multi-modal nature of 'response', show that many responders experience residual symptoms post-biologic-initiation, and that predictors of response vary according to ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
J Allergy Clin Immunol Pract; https://qmro.qmul.ac.uk/xmlui/handle/123456789/97080 |
| DOI: |
10.1016/j.jaip.2024.05.016 |
| Availability: |
https://qmro.qmul.ac.uk/xmlui/handle/123456789/97080; https://doi.org/10.1016/j.jaip.2024.05.016 |
| Rights: |
This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits you to copy and redistribute in any medium or format, for non-commercial use only, provided that the original work is not remixed, transformed, or built upon, and that appropriate credit to the original source is given. For a full description of the license, please visit https://creativecommons.org/licenses/by-nc-nd/4.0/legalcode. |
| Accession Number: |
edsbas.EDC5596F |
| Database: |
BASE |