Anti-Interleukin-5 Therapy Is Associated with Attenuated Lung Function Decline in Severe Eosinophilic Asthma Patients From the Belgian Severe Asthma Registry
| Autor: | Guy Brusselle, Shane Hanon, Sophie Graff, Rudy Peche, Therese Lapperre, Lies Lahousse, Florence Schleich, Carine Sohy, Guy Joos, Alain Michils, Lieven Dupont, Renaud Louis, Charles Pilette |
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| Přispěvatelé: | Clinical sciences, Faculty of Medicine and Pharmacy, Pneumology, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Service de pneumologie, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service de pneumologie |
| Rok vydání: | 2021 |
| Předmět: |
severe asthma
Vital capacity medicine.medical_specialty Population Bronchi decline FEV1/FVC ratio Belgium Interquartile range Internal medicine Forced Expiratory Volume Immunology and Allergy Medicine Humans Registries education Asthma education.field_of_study business.industry mepolizumab lung function respiratory system medicine.disease respiratory tract diseases Asthma Control Questionnaire Salbutamol eosinophils Human medicine business Mepolizumab medicine.drug |
| Zdroj: | The journal of allergy and clinical immunology. In practice The journal of allergy and clinical immunology. In practice, Vol. 10, no. 2, p. 467-477 (2022) |
| ISSN: | 2213-2201 2213-2198 |
| Popis: | BACKGROUND: Asthmatics have accelerated lung function decline over time compared with healthy individuals. OBJECTIVE: To evaluate risk factors for accelerated lung function decline. METHODS: In a longitudinal analysis on severe asthmatics enrolled in the Belgian Severe Asthma Registry with at least 2 visits a minimum of 12 months apart, we compared characteristics of patients with and without decline (loss of postbronchodilation forced expiratory volume in 1 s [FEV1] (% predicted)/y greater than zero) over time. Multiple linear regression was applied to study the factors independently associated with FEV1 decline. RESULTS: In the overall population (n = 318), median annual FEV1 decline was 0.27 (-4.22 to 3.80) % predicted/y over a period of 23 months (12-41 months). Asthma was less controlled at baseline in nondecliners than in decliners (53%). Lung function and residual volume at baseline were higher in the declining group. Decliners presented with increased bronchial reactivity (ie, a lower provocative concentration of methacholine causing a 20% fall in FEV1) at baseline. Twenty-five percent of nondecliners were started on anti-interleukin-5 (anti-IL-5) for severe eosinophilic asthma during the study compared with 10% of decliners. The multivariable model suggested that Asthma Control Questionnaire score at baseline, late-onset asthma, and addition of anti-IL-5 during follow-up were associated with lower FEV1 decline, independently from other variables such as evolution in exacerbations, smoking status, inhaled corticosteroids or oral corticosteroids dose, or add-on anti-immunoglobulin E over time, whereas reversibility to salbutamol and higher FEV1 were associated with accelerated FEV1 decline. CONCLUSIONS: Add-on therapy with anti-IL-5 in severe eosinophilic asthma was associated with an attenuated FEV1 decline. The causality of this observation should, however, be confirmed in future prospective controlled studies. (C) 2021 American Academy of Allergy, Asthma & Immunology |
| Databáze: | OpenAIRE |
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