Biomarkers to Predict Response to Inhaled Corticosteroids and Long-Acting Muscarinic Antagonists in Adolescents and Adults with Mild Persistent Asthma
| Autor: | Mario Castro, David T. Mauger, Tonya S. King, Christine A. Sorkness, Sally E. Wenzel, Njira L Lugogo, Juan Carlos Cardet, Wanda Phipatanakul, Kathryn V. Blake, Ronina A. Covar, Jason E. Lang, Jerry A. Krishnan, Stephen C. Lazarus, Anne-Marie Dyer, Michael E. Wechsler, Elliot Israel |
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| Rok vydání: | 2022 |
| Předmět: |
Adult
Pulmonary and Respiratory Medicine medicine.medical_specialty Adolescent Population Muscarinic Antagonists Placebo law.invention Randomized controlled trial Adrenal Cortex Hormones law Internal medicine Administration Inhalation medicine Humans Prospective Studies education Original Research Asthma education.field_of_study biology business.industry Infant Lama biology.organism_classification medicine.disease Confidence interval Clinical trial Sputum medicine.symptom business Biomarkers |
| Zdroj: | Ann Am Thorac Soc |
| ISSN: | 2325-6621 2329-6933 |
| DOI: | 10.1513/annalsats.202105-613oc |
| Popis: | RATIONALE: Whether biomarkers can be used to predict response to inhaled corticosteroids (ICS) or long-acting muscarinic antagonists (LAMA) in mild persistent asthma is unclear. OBJECTIVES: In a prespecified exploratory analysis of a randomized clinical trial of 295 participants 12 years of age or older with uncontrolled mild persistent asthma, we sought to identify biomarkers of treatment response after 12 weeks of ICS (mometasone, 200 μg or 220 μg twice/d), LAMA (tiotropium, 5 μg/d), or placebo in adults (⩾18 yr) and adolescents (12–17 yr) separately. METHODS: The primary outcome was a composite outcome of asthma control (treatment failure, asthma control days, and forced expiratory volume in 1 second [FEV(1)]). Analyses examined type 2 inflammatory biomarkers and physiologic biomarkers. We assessed the area under the receiver operating characteristic curve (AUC) for response to ICS and LAMA (each versus placebo). An AUC of 0.5 suggests no discrimination, 0.7–0.8 is considered acceptable, more than 0.8–0.9 is considered excellent, and more than 0.9 is considered outstanding. RESULTS: In 237 adults, sputum and blood eosinophil levels and fractional exhaled nitric oxide (Fe(NO)) each predicted ICS response (AUCs: 0.61 [95% confidence interval (CI), 0.53–0.69], 0.64 [95% CI, 0.56–0.72], and 0.62 [95% CI, 0.54–0.70], respectively; all P |
| Databáze: | OpenAIRE |
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