TY - JOUR
T1 - Association Between T2-related Comorbidities and Effectiveness of Biologics in Severe Asthma
AU - Wechsler, Michael E.
AU - Scelo, Ghislaine
AU - Larenas-Linnemann, Désirée E.S.
AU - Torres-Duque, Carlos A.
AU - Maspero, Jorge
AU - Tran, Trung N.
AU - Murray, Ruth B.
AU - Martin, Neil
AU - Menzies-Gow, Andrew N.
AU - Hew, Mark
AU - Peters, Matthew J.
AU - Gibson, Peter G.
AU - Christoff, George C.
AU - Popov, Todor A.
AU - Côté, Andréanne
AU - Bergeron, Celine
AU - Dorscheid, Delbert
AU - FitzGerald, J. Mark
AU - Chapman, Kenneth R.
AU - Boulet, Louis Philippe
AU - Bhutani, Mohit
AU - Sadatsafavi, Mohsen
AU - Jiménez-Maldonado, Libardo
AU - Duran-Silva, Mauricio
AU - Rodriguez, Bellanid
AU - Celis-Preciado, Carlos Andres
AU - Cano-Rosales, Diana Jimena
AU - Solarte, Ivan
AU - Parada-Tovar, Patricia
AU - von Bülow, Anna
AU - Bjerrum, Anne Sofie
AU - Ulrik, Charlotte S.
AU - Assing, Karin Dahl
AU - Rasmussen, Linda Makowska
AU - Hansen, Susanne
AU - Altraja, Alan
AU - Bourdin, Arnaud
AU - Taille, Camille
AU - Charriot, Jeremy
AU - Roche, Nicolas
AU - Papaioannou, Andriana I.
AU - Kostikas, Konstantinos
AU - Papadopoulos, Nikolaos G.
AU - Salvi, Sundeep
AU - Long, Deirdre
AU - Mitchell, Patrick D.
AU - Costello, Richard
AU - Sirena, Concetta
AU - Cardini, Cristina
AU - Heffler, Enrico
AU - Puggioni, Francesca
AU - Canonica, Giorgio Walter
AU - Guida, Giuseppe
AU - Iwanaga, Takashi
AU - Al-Ahmad, Mona
AU - García, Ulises
AU - Kuna, Piotr
AU - Fonseca, João A.
AU - Al-Lehebi, Riyad
AU - Koh, Mariko S.
AU - Rhee, Chin Kook
AU - Cosio, Borja G.
AU - Perez de Llano, Luis
AU - Perng, Diahn Warng Steve
AU - Huang, Erick Wan Chun
AU - Wang, Hao Chien
AU - Tsai, Ming Ju
AU - Mahboub, Bassam
AU - Salameh, Laila Ibraheem Jaber
AU - Jackson, David J.
AU - Busby, John
AU - Heaney, Liam G.
AU - Pfeffer, Paul E.
AU - Goddard, Amanda Grippen
AU - Wang, Eileen
AU - Hoyte, Flavia C.L.
AU - Chapman, Nicholas M.
AU - Katial, Rohit
AU - Carter, Victoria
AU - Bulathsinhala, Lakmini
AU - Eleangovan, Neva
AU - Ariti, Con
AU - Lyu, Juntao
AU - Porsbjerg, Celeste
AU - Price, David B.
AU - Fernandez Sanchez, María José
PY - 2024/1
Y1 - 2024/1
N2 - Rationale: Previous studies investigating the impact of comorbidities on the effectiveness of biologic agents have been relatively small and of short duration and have not compared classes of biologic agents. Objectives: To determine the association between type 2-related comorbidities and biologic agent effectiveness in adults with severe asthma (SA). Methods: This cohort study used International Severe Asthma Registry data from 21 countries (2017-2022) to quantify changes in four outcomes before and after biologic therapy-annual asthma exacerbation rate, FEV1% predicted, asthma control, and long-term oral corticosteroid daily dose-in patients with or without allergic rhinitis, chronic rhinosinusitis (CRS) with or without nasal polyps (NPs), NPs, or eczema/atopic dermatitis. Measurements and Main Results: Of 1,765 patients, 1,257, 421, and 87 initiated anti-IL-5/5 receptor, anti-IgE, and anti-IL-4/13 therapies, respectively. In general, pre- versus post-biologic therapy improvements were noted in all four asthma outcomes assessed, irrespective of comorbidity status. However, patients with comorbid CRS with or without NPs experienced 23% fewer exacerbations per year (95% CI, 10-35%; P < 0.001) and had 59% higher odds of better post-biologic therapy asthma control (95% CI, 26-102%; P < 0.001) than those without CRS with or without NPs. Similar estimates were noted for those with comorbid NPs: 22% fewer exacerbations and 56% higher odds of better post-biologic therapy control. Patients with SA and CRS with or without NPs had an additional FEV1% predicted improvement of 3.2% (95% CI, 1.0-5.3; P = 0.004), a trend that was also noted in those with comorbid NPs. The presence of allergic rhinitis or atopic dermatitis was not associated with post-biologic therapy effect for any outcome assessed. Conclusions: These findings highlight the importance of systematic comorbidity evaluation. The presence of CRS with or without NPs or NPs alone may be considered a predictor of the effectiveness of biologic agents in patients with SA.
AB - Rationale: Previous studies investigating the impact of comorbidities on the effectiveness of biologic agents have been relatively small and of short duration and have not compared classes of biologic agents. Objectives: To determine the association between type 2-related comorbidities and biologic agent effectiveness in adults with severe asthma (SA). Methods: This cohort study used International Severe Asthma Registry data from 21 countries (2017-2022) to quantify changes in four outcomes before and after biologic therapy-annual asthma exacerbation rate, FEV1% predicted, asthma control, and long-term oral corticosteroid daily dose-in patients with or without allergic rhinitis, chronic rhinosinusitis (CRS) with or without nasal polyps (NPs), NPs, or eczema/atopic dermatitis. Measurements and Main Results: Of 1,765 patients, 1,257, 421, and 87 initiated anti-IL-5/5 receptor, anti-IgE, and anti-IL-4/13 therapies, respectively. In general, pre- versus post-biologic therapy improvements were noted in all four asthma outcomes assessed, irrespective of comorbidity status. However, patients with comorbid CRS with or without NPs experienced 23% fewer exacerbations per year (95% CI, 10-35%; P < 0.001) and had 59% higher odds of better post-biologic therapy asthma control (95% CI, 26-102%; P < 0.001) than those without CRS with or without NPs. Similar estimates were noted for those with comorbid NPs: 22% fewer exacerbations and 56% higher odds of better post-biologic therapy control. Patients with SA and CRS with or without NPs had an additional FEV1% predicted improvement of 3.2% (95% CI, 1.0-5.3; P = 0.004), a trend that was also noted in those with comorbid NPs. The presence of allergic rhinitis or atopic dermatitis was not associated with post-biologic therapy effect for any outcome assessed. Conclusions: These findings highlight the importance of systematic comorbidity evaluation. The presence of CRS with or without NPs or NPs alone may be considered a predictor of the effectiveness of biologic agents in patients with SA.
KW - allergic rhinitis
KW - chronic rhinosinusitis
KW - nasal polyposis
UR - http://www.scopus.com/inward/record.url?scp=85184138353&partnerID=8YFLogxK
U2 - 10.1164/rccm.202305-0808OC
DO - 10.1164/rccm.202305-0808OC
M3 - Article
C2 - 38016003
AN - SCOPUS:85184138353
SN - 1073-449X
VL - 209
SP - 262
EP - 272
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
IS - 3
ER -