Exploring Definitions and Predictors of Severe Asthma Clinical Remission after Biologic Treatment in Adults.

Data de publicação:

Autores da FMUP

  • João De Almeida Lopes Da Fonseca

    Autor

Participantes de fora da FMUP

  • Perez-de-Llano L
  • Scelo G
  • Tran TN
  • Le TT
  • Fagerås M
  • Cosio BG
  • Peters M
  • Pfeffer PE
  • Al-Ahmad M
  • Al-Lehebi RO
  • Altraja A
  • Bergeron C
  • Bjermer LH
  • Bjerrum AS
  • Bulathsinhala L
  • Busby J
  • Cano Rosales DJ
  • Canonica GW
  • Carter VA
  • Charriot J
  • Christoff GC
  • Denton EJ
  • Dorscheid DR
  • Fernandez Sanchez MJ
  • Gibson PG
  • Goh CYY
  • Heaney LG
  • Heffler E
  • Hew M
  • Iwanaga T
  • Katial R
  • Koh MS
  • Kuna P
  • Larenas-Linnemann DES
  • Lehtimäki L
  • Mahboub B
  • Martin N
  • Matsumoto H
  • Menzies-Gow AN
  • Papadopoulos NG
  • Popov TA
  • Porsbjerg CM
  • Patel P
  • Rhee CK
  • Sadatsafavi M
  • Taillé C
  • Torres-Duque CA
  • Tsai MJ
  • Ulrik CS
  • Upham JW
  • von Bülow A
  • Wang E
  • Wechsler ME
  • Price DB

Unidades de investigação

Abstract

Rationale: There is no consensus on criteria to include in an asthma remission definition in real life. Factors associated with achieving remission after biologic initiation remain poorly understood. Objectives: To quantify the proportion of adults with severe asthma achieving multidomain-defined remission after biologic initiation and identify prebiologic characteristics associated with achieving remission that 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 before and after biologic initiation. A priori-defined remission cutoffs were: 0 exacerbations/yr, no long-term oral corticosteroid (LTOCS), partly/well-controlled asthma, and percent predicted FEV(1) ? 80%. Remission was defined using two (exacerbations + LTOCS), three (+control or +lung function), and four of these domains. The association between prebiologic characteristics and postbiologic remission was assessed by multivariable analysis. Measurements and Main Results: A total of 50.2%, 33.5%, 25.8%, and 20.3% of patients met criteria for two-, three- (+control), three- (+lung function), and four-domain remission, respectively. The odds of achieving four-domain remission decreased by 15% for every additional 10 years of asthma duration (odds ratio, 0.85; 95% confidence interval, 0.73-1.00). The odds of remission increased in those with fewer exacerbations per year, lower LTOCS daily dose, better control, and better lung function before biologic initiation. Conclusions: One in five patients achieved four-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 after biologic treatment, indicating that biologic treatment should not be delayed if remission is the goal.

Dados da publicação

ISSN/ISSNe:
1073-449X, 1535-4970

American Journal of Respiratory and Critical Care Medicine  American Thoracic Society

Tipo:
Article
Páginas:
869-880

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Keywords

  • anti-IL4Ra; anti-IL5/5R; anti-IgE; exacerbation; lung function

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