TY - JOUR
T1 - Exploring Definitions and Predictors of Severe Asthma Clinical Remission Post-Biologic in Adults
AU - Perez-De-Llano, Luis
AU - Scelo, Ghislaine
AU - Tran, Trung n.
AU - Le, Tham t
AU - Fagerås, Malin
AU - Cosio, Borja g
AU - Peters, Matthew
AU - Pfeffer, Paul e.
AU - Al-Ahmad, Mona
AU - Al-Lehebi, Riyad o.
AU - Altraja, Alan
AU - Bergeron, Celine
AU - Bjermer, Leif h.
AU - Bjerrum, Anne s.
AU - Bulathsinhala, Lakmini
AU - Busby, John
AU - Cano rosales, Diana j.
AU - Canonica, Giorgio w.
AU - Carter, Victoria a.
AU - Charriot, Jeremy
AU - Christoff, George c.
AU - Denton, Eve j.
AU - Dorscheid, Delbert r.
AU - Fernandez sanchez, Maria j.
AU - Fonseca, João a.
AU - Gibson, Peter g
AU - Goh, Celine y.y.
AU - Heaney, Liam g.
AU - Heffler, Enrico
AU - Hew, Mark
AU - Iwanaga, Takashi
AU - Katial, Rohit
AU - Koh, Mariko s.
AU - Kuna, Piotr
AU - Larenas-Linnemann, Désirée e. s.
AU - Lehtimäki, Lauri
AU - Mahboub, Bassam
AU - Martin, Neil
AU - Matsumoto, Hisako
AU - Menzies-Gow, Andrew n.
AU - Papadopoulos, Nikolaos g.
AU - Popov, Todor a.
AU - Porsbjerg, Celeste m.
AU - Patel, Pujan
AU - Rhee, Chin k.
AU - Sadatsafavi, Mohsen
AU - Taillé, Camille
AU - Torres-Duque, Carlos a.
AU - Tsai, Ming-Ju
AU - Ulrik, Charlotte s
AU - Upham, John w.
AU - Von bülow, Anna
AU - Wang, Eileen
AU - Wechsler, Michael e
AU - Price, David b.
PY - 2024/5/3
Y1 - 2024/5/3
N2 - Rationale: There is no consensus on criteria to include in an asthma remission definition in real-life. Factors associated with achieving remission post-biologic-initiation remain poorly understood. Objectives: To quantify the proportion of adults with severe asthma achieving multi-domain-defined remission post-biologic-initiation and identify pre-biologic characteristics associated with achieving remission which may be used to predict it. Methods: This was a longitudinal cohort study using data from 23 countries from the International Severe Asthma Registry. Four asthma outcome domains were assessed in the 1-year pre- and post-biologic-initiation. A priori-defined remission cut-offs were: 0 exacerbations/year, no long-term oral corticosteroid (LTOCS), partly/well-controlled asthma, and percent predicted forced expiratory volume in one second ≥80%. Remission was defined using 2 (exacerbations + LTOCS), 3 (+control or +lung function) and 4 of these domains. The association between pre-biologic characteristics and post-biologic remission was assessed by multivariable analysis. Measurements and main results: 50.2%, 33.5%, 25.8% and 20.3% of patients met criteria for 2, 3 (+control), 3 (+lung function) and 4-domain-remission, respectively. The odds of achieving 4-domain remission decreased by 15% for every additional 10-years asthma duration (odds ratio: 0.85; 95% CI: 0.73, 1.00). The odds of remission increased in those with fewer exacerbations/year, lower LTOCS daily dose, better control and better lung function pre-biologic-initiation. Conclusions: One in 5 patients achieved 4-domain remission within 1-year of biologic-initiation. Patients with less severe impairment and shorter asthma duration at initiation had a greater chance of achieving remission post-biologic, indicating that biologic treatment should not be delayed if remission is the goal. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).
AB - Rationale: There is no consensus on criteria to include in an asthma remission definition in real-life. Factors associated with achieving remission post-biologic-initiation remain poorly understood. Objectives: To quantify the proportion of adults with severe asthma achieving multi-domain-defined remission post-biologic-initiation and identify pre-biologic characteristics associated with achieving remission which may be used to predict it. Methods: This was a longitudinal cohort study using data from 23 countries from the International Severe Asthma Registry. Four asthma outcome domains were assessed in the 1-year pre- and post-biologic-initiation. A priori-defined remission cut-offs were: 0 exacerbations/year, no long-term oral corticosteroid (LTOCS), partly/well-controlled asthma, and percent predicted forced expiratory volume in one second ≥80%. Remission was defined using 2 (exacerbations + LTOCS), 3 (+control or +lung function) and 4 of these domains. The association between pre-biologic characteristics and post-biologic remission was assessed by multivariable analysis. Measurements and main results: 50.2%, 33.5%, 25.8% and 20.3% of patients met criteria for 2, 3 (+control), 3 (+lung function) and 4-domain-remission, respectively. The odds of achieving 4-domain remission decreased by 15% for every additional 10-years asthma duration (odds ratio: 0.85; 95% CI: 0.73, 1.00). The odds of remission increased in those with fewer exacerbations/year, lower LTOCS daily dose, better control and better lung function pre-biologic-initiation. Conclusions: One in 5 patients achieved 4-domain remission within 1-year of biologic-initiation. Patients with less severe impairment and shorter asthma duration at initiation had a greater chance of achieving remission post-biologic, indicating that biologic treatment should not be delayed if remission is the goal. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).
KW - lung function
KW - exacerbation
KW - anti-IL4Rα
KW - anti-IL5/5R
KW - anti-IgE
UR - http://www.ncbi.nlm.nih.gov/pubmed/38701495
UR - https://www.mendeley.com/catalogue/d8acbdfb-00bc-3311-b02c-86547a73b48a/
U2 - 10.1164/rccm.202311-2192oc
DO - 10.1164/rccm.202311-2192oc
M3 - Article
SN - 1073-449X
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
ER -