- Title
- Association Between T2-related Comorbidities and Effectiveness of Biologics in Severe Asthma
- Creator
- Wechsler, Michael E.; Scelo, Ghislaine; Peters, Matthew J.; Gibson, Peter G.; Christoff, George C.; Popov, Todor A.; Côté, Andréanne; Bergeron, Celine; Dorscheid, Delbert; FitzGerald, J. Mark; Chapman, Kenneth R.; Boulet, Louis Philippe; Larenas-Linnemann, Désirée E. S.; Bhutani, Mohit; Sadatsafavi, M; Jiménez-Maldonado, L; Duran-Silva, M; Rodriguez, B; Celis-Preciado, CA; Cano-Rosales, DJ; Solarte, I; Fernandez-Sanchez, MJ; Parada-Tovar, P; Torres-Duque, Carlos A.; von Bülow, A; Bjerrum, AS; Ulrik, CS; Assing, KD; Rasmussen, LM; Hansen, S; Altraja, A; Bourdin, A; Taille, C; Charriot, J; Maspero, Jorge; Roche, N; Papaioannou, AI; Kostikas, K; Papadopoulos, NG; Salvi, S; Long, D; Mitchell, PD; Costello, R; Sirena, C; Cardini, C; Tran, Trung N.; Heffler, E; Puggioni, F; Canonica, GW; Guida, G; Iwanaga, T; Al-Ahmad, M; García, U; Kuna, P; Fonseca, JA; Al-Lehebi, R; Murray, Ruth B.; Koh, MS; Rhee, CK; Cosio, BG; Perez de Llano, L; Perng, D-W; Huang, EW-C; Wang, H-C; Tsai, M-J; Mahboub, B; Salameh, LIJ; Martin, Neil; Jackson, DJ; Busby, J; Heaney, LG; Pfeffer, PE; Goddard, AG; Wang, E; Hoyte, FCL; Chapman, NM; Katial, R; Carter, V; Menzies-Gow, Andrew N.; Bulathsinhala, L; Eleangovan, N; Ariti, C; Lyu, J; Porsbjerg, C; Price, DB; Hew, Mark
- Relation
- American Journal of Respiratory and Critical Care Medicine Vol. 209, Issue 3, p. 262-272
- Publisher Link
- http://dx.doi.org/10.1164/rccm.202305-0808OC
- Publisher
- American Thoracic Society
- Resource Type
- journal article
- Date
- 2024
- Description
- Rationale: Previous studies investigating comorbidity impact on biologic effectiveness have been relatively small, of short duration, and have not compared biologic classes. Objectives: To determine the association between T2-related comorbidities and biologic effectiveness in adults with severe asthma (SA). Methods: This cohort study used International Severe Asthma Registry data (n=21 countries, 2017-2022) to quantify pre- to post-biologic change for four outcomes (annual asthma exacerbation rate, % predicted FEV1 (ppFEV1), asthma control, and long-term oral corticosteroid daily dose [LTOCS]) in patients with/without allergic rhinitis (AR), chronic rhinosinusitis +/- nasal polyps (CRS+/-NP), NP, or eczema/atopic dermatitis (AD). Measurements and Main Results: Of 1765 patients, 1257, 421, and 87 initiated anti-IL-5/5R, anti-IgE, and anti-IL-4/13 therapies, respectively. In general, pre- to post-biologic improvements were noted in all four asthma outcomes assessed, irrespective of comorbidity status. However, patients with comorbid CRS+/-NP experienced 23% (95% CI 10-35%, p<0.001) fewer exacerbations/year and had 59% (95% CI: 26-102%, p<0.001) higher odds of better post-biologic control than those without CRS+/-NP. Similar estimates were noted for those with comorbid NP (22% less exacerbations and 56% higher odds of better post-biologic control). Patients with SA and CRS+/-NP had an additional ppFEV1 improvement of 3.2% (95% CI: 1.0-5.3; p=0.004), a trend that was also noted in those with comorbid NP. The presence of AR or AD were not associated with pre- to post-biologic effect for any outcome assessed. Conclusions: These findings highlight the importance of systematic comorbidity evaluation. The presence of CRS+/-NP or NP may be considered a predictor of biologic effectiveness in patients with severe asthma.
- Subject
- allergic rhinitis; chronic rhinosinusitis; nasal polyposis; asthma; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1497404
- Identifier
- uon:54338
- Identifier
- ISSN:1535-4970
- Language
- eng
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