Long-Term Weight Changes After Starting Anti-IL-5/5Ra Biologics in Severe Asthma: The Role of Oral Corticosteroids.

Autor:	Ten Have L; Department of Epidemiology, Medical Center Leeuwarden, Leeuwarden, The Netherlands; Department of Biomedical Data Science, Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: lianne.ten.have@mcl.nl., Visser E; Department of Epidemiology, Medical Center Leeuwarden, Leeuwarden, The Netherlands., Meulmeester FL; Department of Biomedical Data Science, Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands., Bendien SA; Department of Respiratory Medicine, HAGA Teaching Hospital, Den Haag, The Netherlands., Braunstahl GJ; Department of Respiratory Medicine, St Franciscus Gasthuis en Vlietland, Rotterdam, The Netherlands., Broeders MEAC; Department of Respiratory Medicine, Jeroen Bosch Hospital, 's Hertogenbosch, The Netherlands., Fieten KB; Nederlands Astmacentrum Davos, Davos, Switzerland; Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Zurich, Switzerland., Hashimoto S; Department of Pulmonary Medicine, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands., van Huisstede A; Department of Pulmonary Medicine, Northwest Clinics, Alkmaar, The Netherlands., Langeveld B; Department of Respiratory Medicine, Deventer Ziekenhuis, Deventer, The Netherlands., Oud KTM; Department of Respiratory Medicine, Ziekenhuis Gelderse Vallei, Ede, The Netherlands., Patberg KW; Department of Respiratory Medicine, ISALA Clinics, Zwolle, The Netherlands., Smeenk FWJM; Department of Respiratory Medicine, Catharina Hospital, Eindhoven, The Netherlands., van Veen A; Department of Respiratory Medicine, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands., van Veen IH; Department of Respiratory Medicine, Medisch Spectrum Twente, Enschede, The Netherlands., van de Ven MJT; Department of Respiratory Medicine, Rijnstate Hospital, Arnhem, The Netherlands., Weersink EJM; Department of Pulmonary Medicine, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands., de Jong K; Department of Epidemiology, Medical Center Leeuwarden, Leeuwarden, The Netherlands., Sont JK; Department of Biomedical Data Science, Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands., Kroes JA; Department of Clinical Pharmacy and Pharmacology, Medical Center Leeuwarden, Leeuwarden, The Netherlands., Ten Brinke A; Department of Pulmonary Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands.
Jazyk:	angličtina
Zdroj:	The journal of allergy and clinical immunology. In practice [J Allergy Clin Immunol Pract] 2023 Sep; Vol. 11 (9), pp. 2748-2756.e3. Date of Electronic Publication: 2023 Jul 01.
DOI:	10.1016/j.jaip.2023.06.054
Abstrakt:	Background: Many patients with severe asthma are overweight or obese, often attributed to unintentional weight gain as a side effect of oral corticosteroids (OCSs). Anti-IL-5/5Ra biologics significantly reduce OCS use, but their long-term effects on weight are unknown. Objectives: To examine (1) weight change up to 2 years after anti-IL-5/5Ra initiation in subgroups on the basis of maintenance OCS use at start of treatment and (2) whether cumulative OCS exposure before or changes in OCS exposure during treatment are related to weight change. Methods: Real-world data on weight and cumulative OCS dose from adults included in the Dutch Registry of Adult Patients with Severe asthma for Optimal DIsease management before and at least 2 years after starting anti-IL-5/5Ra were analyzed using linear mixed models and linear regression analyses. Results: For the included 389 patients (55% female; mean body mass index, 28 ± 5 kg/m 2 ; 58% maintenance OCS), mean weight decreased -0.27 kg/y (95% CI, -0.51 to -0.03; P = .03), with more weight loss in patients with maintenance OCS use than in those without maintenance OCS use (-0.87 kg/y [95% CI, -1.21 to -0.52; P < .001] vs +0.54 kg/y [0.26 to 0.82; P < .001]). Greater weight loss at 2 years was associated with higher cumulative OCS dose in the 2 years before anti-IL-5/5Ra initiation (β = -0.24 kg/g; 95% CI, -0.38 to -0.10; P < .001) and, independently, greater reduction in cumulative OCS dose during follow-up (β = 0.27 kg/g; 95% CI, 0.11 to 0.43; P < .001). Conclusions: Anti-IL-5/5Ra therapy is associated with long-term weight reduction, especially in patients with higher OCS exposure before treatment and those able to reduce OCS use during treatment. However, the effect is small and does not apply to all patients, and so additional interventions seem necessary if weight change is desired. (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu