Real-World Effectiveness of IL-5/5Ra Targeted Biologics in Severe Eosinophilic Asthma With Comorbid Bronchiectasis

被引：10

作者：

Bendien, Sarah A. ^{[1
,18
]}

Kroes, Johannes A. ^{[2
]}

van Hal, Lotte H. G. ^{[2
]}

Braunstahl, Gert-Jan ^{[3
]}

Broeders, Marielle E. A. C. ^{[4
]}

Oud, Karen T. M. ^{[5
]}

Patberg, Kornelis Wiebe ^{[6
]}

Smeenk, Frank W. J. M. ^{[7
]}

van Veen, Ilonka H. P. A. A. ^{[8
]}

Weersink, Els J. M. ^{[9
]}

Fieten, Karin B. ^{[10
,11
]}

Hashimoto, Simone ^{[9
]}

van Veen, Anneke ^{[12
]}

Sont, Jaap K. ^{[13
]}

van Huisstede, Astrid ^{[14
]}

van de Ven, Marjo J. T. ^{[15
]}

Langeveld, Bas ^{[16
]}

Zee, Anke-Hilse Maitland-van der ^{[9
]}

机构：

[1] HAGA Teaching Hosp, Dept Pulmonol, The Hague, Netherlands

[2] Med Ctr Leeuwarden, Dept Clin Pharm & Pharmacol, Leeuwarden, Netherlands

[3] Franciscus Gasthuis & Vlietland, Dept Pulm Med, Rotterdam, Netherlands

[4] Jeroen Bosch Hosp, Dept Geriatr Med, Shertogenbosch, Netherlands

[5] Ziekenhuis Gelderse Vallei, Dept Resp Med, Ede, Netherlands

[6] ISALA Clin, Dept Resp Med, Zwolle, Netherlands

[7] Catharina Hosp, Dept Resp Med, Eindhoven, Netherlands

[8] Med Spectrum Twente, Dept Resp Med, Enschede, Netherlands

[9] Amsterdam UMC locat Univ Amsterdam, Dept Pulm Med, Amsterdam, Netherlands

[10] Dutch Asthma Ctr Davos NAD, Davos, Switzerland

[11] Univ Zurich, Swiss Inst Allergy & Asthma Res, Davos, Switzerland

[12] Canisius Wilhelmina Ziekenhuis, Dept Resp Med, Nijmegen, Netherlands

[13] Leiden Univ Med Ctr, Dept Biomed Data Sci, Med Decis Making Sect, Leiden, Netherlands

[14] Noordwest Ziekenhuisgroep, Dept Pulmonol, Alkmaar, Netherlands

[15] Rijnstate Hosp Arnhem, Dept Pulmonol, Arnhem, Netherlands

[16] Deventer Ziekenhuis, Dept Pulmonol, Deventer, Netherlands

[17] Med Ctr Leeuwarden, Dept Pulmonol, Leeuwarden, Netherlands

[18] Haga Teaching Hosp, Dept Hematol, Els Borst-Eilersplein 275, NL-2545 AA The Hague, Netherlands

来源：

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE | 2023年 / 11卷 / 09期

关键词：

Severe asthma; Bronchiectasis; Biologic therapy; Oral corticosteroids; MEPOLIZUMAB; OMALIZUMAB; EFFICACY; CORTICOSTEROIDS; BENRALIZUMAB; MULTICENTER; THERAPY;

D O I：

10.1016/j.jaip.2023.05.041

中图分类号：

R392 [医学免疫学];

学科分类号：

100102 ;

摘要：

BACKGROUND: Bronchiectasis is a common comorbidity in patients with asthma and is associated with increased disease severity. In patients with severe eosinophilic asthma, biologics targeting IL-5/5Ra have beneficial effects on oral corticosteroid (OCS) use and exacerbation frequency. However, how coexisting bronchiectasis affects the response to such treatments is unknown.OBJECTIVE: To evaluate the real-world effectiveness of anti-IL-5/5Ra therapy in patients with severe eosinophilic asthma and comorbid bronchiectasis on exacerbation frequency and daily maintenance and cumulative OCS dose.METHODS: This real-world study evaluated data from 97 adults with severe eosinophilic asthma and computed tomographyeconfirmed bronchiectasis from the Dutch Severe Asthma Registry, who initiated anti-IL5/5Ra biologics (mepolizumab, reslizumab, and benralizumab) and had follow-up data for 12 months or greater. The analysis was performed for the total population and subgroups with or without maintenance OCS use.RESULTS: Anti-IL-5/5Ra therapy significantly reduced exacerbation frequency in patients with maintenance OCS use as well as in those without it. In the year before biologic initiation, 74.5% of all patients had two or more exacerbations, which decreased to 22.1% in the follow-up year (P < .001). The proportion of patients on maintenance OCS decreased from 47% to 30% (P < .001), and in the OCS-dependent patients (n [ 45) maintenance OCS dose decreased from median (interquartile range) of 10.0 mg/d (5-15 mg/d) to 2.5 mg/d (0-5 mg/d) after 1 year (P < .001).CONCLUSIONS: This real-world study shows that anti-IL-5/ 5Ra therapy reduces exacerbation frequency and daily maintenance as well as the cumulative OCS dose in patients with severe eosinophilic asthma and comorbid bronchiectasis. Although it is an exclusion criterion in phase 3 trials, comorbid bronchiectasis should not preclude anti-IL-5/5Ra therapy in patients with severe eosinophilic asthma. (c) 2023 American Academy of Allergy, Asthma & Immunology (J Allergy Clin Immunol Pract 2023;11:2724-31)

引用

页码：2724 / +

页数：10

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