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Biologics (mepolizumab and omalizumab) induced remission in severe asthma patients.
Thomas, Dennis; McDonald, Vanessa M; Stevens, Sean; Harvey, Erin S; Baraket, Melissa; Bardin, Philip; Bowden, Jeffrey J; Bowler, Simon; Chien, Jimmy; Chung, Li Ping; Gillman, Andrew; Hew, Mark; Hodge, Sandra; James, Alan; Jenkins, Christine; Katelaris, Constance H; Katsoulotos, Gregory P; Langton, David; Lee, Joy; Marks, Guy; Peters, Matthew; Radhakrishna, Naghmeh; Reynolds, Paul N; Rimmer, Janet; Sivakumaran, Pathmanathan; Upham, John W; Wark, Peter; Yang, Ian A; Gibson, Peter G.
Afiliación
  • Thomas D; Centre of Excellence in Treatable Traits, College of Health, Medicine and Wellbeing, University of Newcastle, Hunter Medical Research Institute Asthma and Breathing Programme, Newcastle, New South Wales, Australia.
  • McDonald VM; Centre of Excellence in Treatable Traits, College of Health, Medicine and Wellbeing, University of Newcastle, Hunter Medical Research Institute Asthma and Breathing Programme, Newcastle, New South Wales, Australia.
  • Stevens S; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia.
  • Harvey ES; Centre of Excellence in Treatable Traits, College of Health, Medicine and Wellbeing, University of Newcastle, Hunter Medical Research Institute Asthma and Breathing Programme, Newcastle, New South Wales, Australia.
  • Baraket M; Centre of Excellence in Treatable Traits, College of Health, Medicine and Wellbeing, University of Newcastle, Hunter Medical Research Institute Asthma and Breathing Programme, Newcastle, New South Wales, Australia.
  • Bardin P; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia.
  • Bowden JJ; South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
  • Bowler S; Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.
  • Chien J; Lung and Sleep Medicine, Monash University and Medical Centre and Hudson Institute, Clayton, Victoria, Australia.
  • Chung LP; Respiratory and Sleep Services, Flinders Medical Centre and Flinders University, Bedford Park, South Australia, Australia.
  • Gillman A; Department of Respiratory Medicine, Mater Hospital, Brisbane, Queensland, Australia.
  • Hew M; Department of Sleep and Respiratory Medicine, Westmead Hospital, Westmead, New South Wales, Australia.
  • Hodge S; School of Medicine, The University of Sydney, Sydney, New South Wales, Australia.
  • James A; Department of Respiratory Medicine, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
  • Jenkins C; Allergy, Asthma and Clinical Immunology, Alfred Health, Melbourne, Victoria, Australia.
  • Katelaris CH; Allergy, Asthma and Clinical Immunology, Alfred Health, Melbourne, Victoria, Australia.
  • Katsoulotos GP; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
  • Langton D; Lung Research Laboratory, Hanson Institute, Adelaide, South Australia, Australia.
  • Lee J; Department of Thoracic Medicine, Royal Adelaide Hospital, Lung Research, University of Adelaide, Adelaide, South Australia, Australia.
  • Marks G; Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
  • Peters M; Medcial School, The University of Western Australia, Perth, Western Australia, Australia.
  • Radhakrishna N; Department of Thoracic Medicine, Concord Hospital, Concord, New South Wales, Australia.
  • Reynolds PN; Concord Clinical School, University of Sydney, Concord, New South Wales, Australia.
  • Rimmer J; School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia.
  • Sivakumaran P; Immunology and Allergy Unit, Campbelltown Hospital, Campbelltown, New South Wales, Australia.
  • Upham JW; Woolcock Institute of Medical Research, University of Sydney, Glebe, New South Wales, Australia.
  • Wark P; The University of Notre Dame, Sydney, Western Australia, Australia.
  • Yang IA; St George Specialist Centre, Kogarah, New South Wales, Australia.
  • Gibson PG; St Vincent's Clinic, Darlinghurst, New South Wales, Australia.
Allergy ; 79(2): 384-392, 2024 Feb.
Article en En | MEDLINE | ID: mdl-37632144
ABSTRACT

BACKGROUND:

Asthma remission has emerged as a potential treatment goal. This study evaluated the effectiveness of two biologics (mepolizumab/omalizumab) in achieving asthma remission.

METHODS:

This observational study included 453 severe asthma patients (41% male; mean age ± SD 55.7 ± 14.7 years) from two real-world drug registries the Australian Mepolizumab Registry and the Australian Xolair Registry. The composite outcome clinical remission was defined as zero exacerbations and zero oral corticosteroids during the previous 6 months assessed at 12 months and 5-item Asthma Control Questionnaire (ACQ-5) ≤1 at 12 months. We also assessed clinical remission plus optimization (post-bronchodilator FEV1 ≥80%) or stabilization (post-bronchodilator FEV1 not greater than 5% decline from baseline) of lung function at 12 months. Sensitivity analyses explored various cut-offs of ACQ-5/FEV1 scores. The predictors of clinical remission were identified.

RESULTS:

29.3% (73/249) of AMR and 22.8% (37/162) of AXR cohort met the criteria for clinical remission. When lung function criteria were added, the remission rates were reduced to 25.2% and 19.1%, respectively. Sensitivity analyses identified that the remission rate ranged between 18.1% and 34.9% in the AMR cohort and 10.6% and 27.2% in the AXR cohort. Better lung function, lower body mass index, mild disease and absence of comorbidities such as obesity, depression and osteoporosis predicted the odds of achieving clinical remission.

CONCLUSION:

Biologic treatment with mepolizumab or omalizumab for severe asthma-induced asthma remission in a subgroup of patients. Remission on treatment may be an achievable treatment target and future studies should consider remission as an outcome measure.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Asma / Productos Biológicos / Antiasmáticos / Anticuerpos Monoclonales Humanizados Tipo de estudio: Observational_studies / Prognostic_studies Límite: Female / Humans / Male País/Región como asunto: Oceania Idioma: En Revista: Allergy Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: DENMARK / DINAMARCA / DK

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Asma / Productos Biológicos / Antiasmáticos / Anticuerpos Monoclonales Humanizados Tipo de estudio: Observational_studies / Prognostic_studies Límite: Female / Humans / Male País/Región como asunto: Oceania Idioma: En Revista: Allergy Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: DENMARK / DINAMARCA / DK