Portal de investigação
Association between pre-biologic T2-biomarker combinations and response to biologics in patients with severe asthma.
Data de publicação:
Data Ahead of Print:
Autores da FMUP
Participantes de fora da FMUP
- Porsbjerg CM
- Townend J
- Bergeron C
- Christoff GC
- Katsoulotos GP
- Larenas-Linnemann D
- Tran TN
- Al-Lehebi R
- Bosnic-Anticevich SZ
- Busby J
- Hew M
- Kostikas K
- Papadopoulos NG
- Pfeffer PE
- Popov TA
- Rhee CK
- Sadatsafavi M
- Tsai MJ
- Ulrik CS
- Al-Ahmad M
- Altraja A
- Beastall A
- Bulathsinhala L
- Carter V
- Cosio BG
- Fletton K
- Hansen S
- Heaney LG
- Hubbard RB
- Kuna P
- Murray RB
- Nagano T
- Pini L
- Cano Rosales DJ
- Schleich F
- Wechsler ME
- Amaral R
- Bourdin A
- Brusselle GG
- Chen W
- Chung LP
- Denton E
- Hoyte F
- Jackson DJ
- Katial R
- Kirenga BJ
- Koh MS
- Lawkiedraj A
- Lehtimäki L
- Liew MF
- Mahboub B
- Martin N
- Menzies-Gow AN
- Pang PH
- Papaioannou AI
- Patel PH
- Perez-De-Llano L
- Peters MJ
- Ricciardi L
- Rodríguez-Cáceres B
- Solarte I
- Tay TR
- Torres-Duque CA
- Wang E
- Zappa M
- Abisheganaden J
- Assing KD
- Costello RW
- Gibson PG
- Heffler E
- Máspero J
- Nicola S
- Perng Steve DW
- Puggioni F
- Salvi S
- Sheu CC
- Sirena C
- Taillé C
- Tan TL
- Bjermer L
- Canonica GW
- Iwanaga T
- Jiménez-Maldonado L
- Taube C
- Brussino L
- Price DB
Unidades de investigação
Abstract
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 pre-biologic BEC and FeNO were both associated with greater post-biologic improvement in FEV(1) for both anti-IgE and anti-IL5/5R, with a trend for anti-IL4Ra. Mean FEV(1) 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-IL4Ra, 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-IL4Ra, respectively. Higher baseline BEC was also associated with lower probability of uncontrolled asthma (OR 0.392; p=0.001) post-biologic for anti-IL5/5R. Pre-biologic 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 FEV(1) increase (adjusted R(2): 0.751), compared to BEC (adjusted R(2): 0.747) or FeNO alone (adjusted R(2): 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.
Copyright © 2024 Porsbjerg, Townend, Bergeron, Christoff, Katsoulotos, Larenas-Linnemann, Tran, Al-Lehebi, Bosnic-Anticevich, Busby, Hew, Kostikas, Papadopoulos, Pfeffer, Popov, Rhee, Sadatsafavi, Tsai, Ulrik, Al-Ahmad, Altraja, Beastall, Bulathsinhala, Carter, Cosio, Fletton, Hansen, Heaney, Hubbard, Kuna, Murray, Nagano, Pini, Cano Rosales, Schleich, Wechsler, Amaral, Bourdin, Brusselle, Chen, Chung, Denton, Fonseca, Hoyte, Jackson, Katial, Kirenga, Koh, Lawkiedraj, Lehtimäki, Liew, Mahboub, Martin, Menzies-Gow, Pang, Papaioannou, Patel, Perez-De-Llano, Peters, Ricciardi, Rodríguez-Cáceres, Solarte, Tay, Torres-Duque, Wang, Zappa, Abisheganaden, Assing, Costello, Gibson, Heffler, Máspero, Nicola, Perng (Steve), Puggioni, Salvi, Sheu, Sirena, Taillé, Tan, Bjermer, Canonica, Iwanaga, Jiménez-Maldonado, Taube, Brussino and Price.
Dados da publicação
- ISSN/ISSNe:
- 1664-3224, 1664-3224
- Tipo:
- Article
- Páginas:
- 1361891-1361891
- PubMed:
- 38711495
- Link para outro recurso:
- www.scopus.com
Frontiers in Immunology Frontiers Media S.A.
Citações Recebidas na Web of Science: 1
Citações Recebidas na Scopus: 1
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Filiações
Keywords
- FEV1; FeNO (Fraction of exhaled Nitric Oxide); biologics; biomarkers; eosinophil (EOS); personalized medicine (PM); severe asthma
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