التفاصيل البيبلوغرافية
| العنوان: |
Association between pre-biologic T2-biomarker combinations and response to biologics in patients with severe asthma. |
| المؤلفون: |
Porsbjerg, Celeste M., Townend, John, Bergeron, Celine, Christoff, George C., Katsoulotos, Gregory P., Larenas-Linnemann, Désirée, Trung N. Tran, Al-Lehebi, Riyad, Bosnic-Anticevich, Sinthia Z., Busby, John, Hew, Mark, Kostikas, Konstantinos, Papadopoulos, Nikolaos G., Pfeffer, Paul E., Popov, Todor A., Chin Kook Rhee, Sadatsafavi, Mohsen, Ming-Ju Tsai, Suppli Ulrik, Charlotte, Al-Ahmad, Mona |
| المصدر: |
Frontiers in Immunology; 5/6/2024, p01-21, 21p |
| مصطلحات موضوعية: |
ASTHMATICS, IMMUNOGLOBULIN E, BIOLOGICALS, LUNGS, NITRIC oxide, WHEEZE |
| مستخلص: |
Background: To date, studies investigating the association between pre-biologic biomarker levels and post-biologic outcomes have been limited to single biomarkers and assessment of biologic efficacy from structured clinical trials. Aim: To elucidate the associations of pre-biologic individual biomarker levels or their combinations with pre-to-post biologic changes in asthma outcomes in real-life. Methods: This was a registry-based, cohort study using data from 23 countries, which shared data with the International Severe Asthma Registry (May 2017-February 2023). The investigated biomarkers (highest pre-biologic levels) were immunoglobulin E (IgE), blood eosinophil count (BEC) and fractional exhaled nitric oxide (FeNO). Pre- to approximately 12-month post-biologic change for each of three asthma outcome domains (i.e. exacerbation rate, symptom control and lung function), and the association of this change with pre-biologic biomarkers was investigated for individual and combined biomarkers. Results: Overall, 3751 patients initiated biologics and were included in the analysis. No association was found between pre-biologic BEC and pre-to-post biologic change in exacerbation rate for any biologic class. However, higher prebiologic BEC and FeNO were both associated with greater post-biologic improvement in FEV1 for both anti-IgE and anti-IL5/5R, with a trend for anti-IL4Rα. Mean FEV1 improved by 27-178 mL post-anti-IgE as pre-biologic BEC increased (250 to 1000 cells/µL), and by 43-216 mL and 129-250 mL post-anti-IL5/5R and -anti-IL4Rα, respectively along the same BEC gradient. Corresponding improvements along a FeNO gradient (25-100 ppb) were 41-274 mL, 69-207 mL and 148-224 mL for anti-IgE, anti-IL5/5R, and anti-IL4Rα, respectively. Higher baseline BEC was also associated with lower probability of uncontrolled asthma (OR 0.39; p=0.001) post-biologic for anti-IL5/5R. Prebiologic IgE was a poor predictor of subsequent pre-to-post-biologic change for all outcomes assessed for all biologics. The combination of BEC + FeNO marginally improved the prediction of post-biologic FEV1 increase (adjusted R²: 0.751), compared to BEC (adjusted R²: 0.747) or FeNO alone (adjusted R²: 0.743) (p=0.005 and <0.001, respectively); however, this prediction was not improved by the addition of IgE. Conclusions: The ability of higher baseline BEC, FeNO and their combination to predict biologic-associated lung function improvement may encourage earlier intervention in patients with impaired lung function or at risk of accelerated lung function decline. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
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