Exploring Definitions and Predictors of Response to Biologics for Severe Asthma.
| Autor: | Scelo G; Observational and Pragmatic Research Institute, Singapore; Optimum Patient Care Global, Cambridge, United Kingdom., Tran TN; BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, Md., Le TT; BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, Md., Fagerås M; BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, Md; BioPharmaceuticals Medical, AstraZeneca, Gothenburg, Sweden., Dorscheid D; Center for Heart Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada., Busby J; Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, United Kingdom., Al-Ahmad M; Microbiology Department, College of Medicine, Kuwait University Al-Rashed Allergy Center, Ministry of Health, Kuwait., Al-Lehebi R; Department of Pulmonology, King Fahad Medical City Alfaisal University, Riyadh, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia., Altraja A; Department of Pulmonology, University of Tartu and Lung Clinic, Tartu University Hospital, Tartu, Estonia., Beastall A; Optimum Patient Care Global, Cambridge, United Kingdom., Bergeron C; Centre for Lung Health, Vancouver General Hospital and University of British Columbia, Vancouver, British Columbia, Canada., Bjermer L; Respiratory Medicine and Allergology, Department of Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden., Bjerrum AS; Department of Respiratory Medicine and Allergy, Aarhus University Hospital, Aarhus, Denmark., Cano-Rosales DJ; Instituto Neumológico del Oriente, Bucaramanga, Santander, Colombia., Canonica GW; Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy., Carter V; Observational and Pragmatic Research Institute, Singapore; Optimum Patient Care Global, Cambridge, United Kingdom., Charriot J; PhyMedExp, Univ Montpellier, CNRS, INSERM, CHU Montpellier, Montpellier, France., Christoff GC; Faculty of Public Health, Medical University, Sofia, Bulgaria., Cosio BG; Son Espases University Hospital, IdISBa-Ciberes, Mallorca, Spain., Denton E; Allergy, Asthma, and Clinical Immunology, Alfred Health, Melbourne, Victoria, Australia; Department of Medicine, Central Clinical School, Monash University, Melbourne, Victoria, Australia., Fernandez-Sanchez MJ; Pulmonary Unit, Hospital Universitario San Ignacio, Bogotá, Colombia; Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia., Fonseca JA; CINTESIS@RISE, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal., Gibson PG; Australian Severe Asthma Network, Priority Research Centre for Healthy Lungs, University of Newcastle, Newcastle, New South Wales, Australia; Department of Respiratory and Sleep Medicine, Hunter Medical Research Institute, John Hunter Hospital, Newcastle, New South Wales, Australia., Goh C; Observational and Pragmatic Research Institute, Singapore; Optimum Patient Care Global, Cambridge, United Kingdom., Heaney LG; Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom., Heffler E; Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy., Hew M; Allergy, Asthma, and Clinical Immunology, Alfred Health, Melbourne, Victoria, Australia; Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Iwanaga T; Center for General Medical Education and Clinical Training, Kindai University Hospital, Osakasayama, Japan., Katial R; Division of Allergy and Clinical Immunology, Department of Medicine, National Jewish Health, Denver, Colo., Koh MS; Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore., Kuna P; Division of Internal Medicine Asthma and Allergy, Medical University of Lodz, Lodz, Poland., Larenas-Linnemann D; Centro de Excelencia en Asma y Alergia, Hospital Médica Sur, Mexico City, Mexico., Lehtimäki L; Allergy Centre, Tampere University Hospital, Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland., Mahboub B; Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates., Martin N; BioPharmaceuticals Medical, AstraZeneca, Cambridge, United Kingdom., Matsumoto H; Department of Respiratory Medicine, and Allergology, Kindai University Faculty of Medicine, Osakasayama, Japan., Menzies-Gow AN; BioPharmaceuticals Medical, AstraZeneca, Cambridge, United Kingdom., Papadopoulos NG; Centre for Respiratory Medicine and Allergy, Division of Infection, Immunity, and Respiratory Medicine, University of Manchester, Manchester, United Kingdom; Allergy and Clinical Immunology Unit, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece., Patel P; Respiratory Medicine, Royal Brompton Hospital, London, United Kingdom., Perez-De-Llano L; Pneumology Service. Lucus Augusti University Hospital, EOXI Lugo, Monforte, Cervo, Spain., Peters M; Department of Thoracic Medicine, Concord Hospital, Sydney, New South Wales, Australia., Pfeffer PE; Department of Respiratory Medicine, Barts Health NHS Trust, Barts and London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom., Popov TA; Clinic of Allergy and Asthma, University Hospital Sv. Ivan Rilski, Sofia, Bulgaria., Porsbjerg CM; Bispebjerg Hospital, Department of Respiratory Medicine and Infectious Diseases, Research Unit, Copenhagen, Denmark., Rhee CK; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea., Sadatsafavi M; Respiratory Evaluation Sciences Program, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada., Taillé C; Department of Respiratory Diseases, Bichat Hospital, AP-HP Nord-Université Paris Cité, Paris, France., Torres-Duque CA; CINEUMO, Respiratory Research Center, Fundación Neumológica Colombiana, Bogotá, Colombia., Tsai MJ; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan., Ulrik CS; Department of Respiratory Medicine, Copenhagen University Hospital, Hvidovre, Denmark., Upham JW; Frazer Institute & PA-Southside Clinical Unit, University of Queensland, Brisbane, Queensland, Australia., von Bülow A; Respiratory Research Unit-Hvidovre, Department of Respiratory Medicine and Infectious Diseases, Bispebjerg Hospital, Copenhagen, Denmark., Wang E; National Jewish Health and University of Colorado School of Medicine, Denver and Aurora, Colo., Wechsler ME; National Jewish Health Cohen Family Asthma Institute, Department of Medicine, National Jewish Health, Denver, Colo., Price DB; Observational and Pragmatic Research Institute, Singapore; Optimum Patient Care Global, Cambridge, United Kingdom; Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom. Electronic address: dprice@opri.sg. |
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| Jazyk: | angličtina |
| Zdroj: | The journal of allergy and clinical immunology. In practice [J Allergy Clin Immunol Pract] 2024 Sep; Vol. 12 (9), pp. 2347-2361. Date of Electronic Publication: 2024 May 19. |
| DOI: | 10.1016/j.jaip.2024.05.016 |
| Abstrakt: | Background: Biologic effectiveness is often assessed as response, a term that 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 four asthma outcome domains were assessed in the 1-year period before and after biologic initiation in patients with a predefined level of prebiologic impairment. Responder cutoffs were 50% or greater reduction in exacerbation rate, 50% or greater reduction in long-term oral corticosteroid daily dose, improvement in one or more category in asthma control, and 100 mL or greater improvement in FEV Results: A total of 2,210 patients were included. Responder rate ranged from 80.7% (n = 566 of 701) for exacerbation response to 10.6% (n = 9 of 85) for a four-domain response. Many responders still exhibited significant impairment after biologic initiation: 46.7% (n = 206 of 441) of asthma control responders with uncontrolled asthma before the biologic still had incompletely controlled disease postbiologic initiation. Predictors of response were outcome-dependent. Lung function responders were more likely to have higher prebiologic FeNO (odds ratio = 1.20 for every 25-parts per billion increase), and shorter asthma duration (odds ratio = 0.81 for every 10-year increase in duration). Higher blood eosinophil count and the presence of type 2-related comorbidities were positively associated with higher odds of meeting long-term oral corticosteroid, control, and lung function responder criteria. Conclusions: Our findings underscore the multimodal nature of response, showing that many responders experience residual symptoms after biologic initiation and that predictors of response vary according to the outcome assessed. (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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