Anti-Interleukin-5 Therapy Is Associated with Attenuated Lung Function Decline in Severe Eosinophilic Asthma Patients From the Belgian Severe Asthma Registry
Copyright © 2021 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved..
BACKGROUND: Asthmatics have accelerated lung function decline over time compared with healthy individuals.
OBJECTIVE: To evaluate risk factors for accelerated lung function decline.
METHODS: In a longitudinal analysis on severe asthmatics enrolled in the Belgian Severe Asthma Registry with at least 2 visits a minimum of 12 months apart, we compared characteristics of patients with and without decline (loss of post-bronchodilation forced expiratory volume in 1 s [FEV1] (% predicted)/y greater than zero) over time. Multiple linear regression was applied to study the factors independently associated with FEV1 decline.
RESULTS: In the overall population (n = 318), median annual FEV1 decline was 0.27 (-4.22 to 3.80) % predicted/y over a period of 23 months (12-41 months). Asthma was less controlled at baseline in nondecliners than in decliners (53%). Lung function and residual volume at baseline were higher in the declining group. Decliners presented with increased bronchial reactivity (ie, a lower provocative concentration of methacholine causing a 20% fall in FEV1) at baseline. Twenty-five percent of nondecliners were started on anti-interleukin-5 (anti-IL-5) for severe eosinophilic asthma during the study compared with 10% of decliners. The multivariable model suggested that Asthma Control Questionnaire score at baseline, late-onset asthma, and addition of anti-IL-5 during follow-up were associated with lower FEV1 decline, independently from other variables such as evolution in exacerbations, smoking status, inhaled corticosteroids or oral corticosteroids dose, or add-on anti-immunoglobulin E over time, whereas reversibility to salbutamol and higher FEV1 were associated with accelerated FEV1 decline.
CONCLUSIONS: Add-on therapy with anti-IL-5 in severe eosinophilic asthma was associated with an attenuated FEV1 decline. The causality of this observation should, however, be confirmed in future prospective controlled studies.
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2022 |
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Erschienen: |
2022 |
Enthalten in: |
Zur Gesamtaufnahme - volume:10 |
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Enthalten in: |
The journal of allergy and clinical immunology. In practice - 10(2022), 2 vom: 01. Feb., Seite 467-477 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Graff, Sophie [VerfasserIn] |
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Links: |
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Themen: |
Decline |
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Anmerkungen: |
Date Completed 18.02.2022 Date Revised 18.02.2022 published: Print-Electronic Citation Status MEDLINE |
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doi: |
10.1016/j.jaip.2021.09.023 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM331053896 |
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520 | |a Copyright © 2021 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved. | ||
520 | |a BACKGROUND: Asthmatics have accelerated lung function decline over time compared with healthy individuals | ||
520 | |a OBJECTIVE: To evaluate risk factors for accelerated lung function decline | ||
520 | |a METHODS: In a longitudinal analysis on severe asthmatics enrolled in the Belgian Severe Asthma Registry with at least 2 visits a minimum of 12 months apart, we compared characteristics of patients with and without decline (loss of post-bronchodilation forced expiratory volume in 1 s [FEV1] (% predicted)/y greater than zero) over time. Multiple linear regression was applied to study the factors independently associated with FEV1 decline | ||
520 | |a RESULTS: In the overall population (n = 318), median annual FEV1 decline was 0.27 (-4.22 to 3.80) % predicted/y over a period of 23 months (12-41 months). Asthma was less controlled at baseline in nondecliners than in decliners (53%). Lung function and residual volume at baseline were higher in the declining group. Decliners presented with increased bronchial reactivity (ie, a lower provocative concentration of methacholine causing a 20% fall in FEV1) at baseline. Twenty-five percent of nondecliners were started on anti-interleukin-5 (anti-IL-5) for severe eosinophilic asthma during the study compared with 10% of decliners. The multivariable model suggested that Asthma Control Questionnaire score at baseline, late-onset asthma, and addition of anti-IL-5 during follow-up were associated with lower FEV1 decline, independently from other variables such as evolution in exacerbations, smoking status, inhaled corticosteroids or oral corticosteroids dose, or add-on anti-immunoglobulin E over time, whereas reversibility to salbutamol and higher FEV1 were associated with accelerated FEV1 decline | ||
520 | |a CONCLUSIONS: Add-on therapy with anti-IL-5 in severe eosinophilic asthma was associated with an attenuated FEV1 decline. The causality of this observation should, however, be confirmed in future prospective controlled studies | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Research Support, Non-U.S. Gov't | |
650 | 4 | |a Decline | |
650 | 4 | |a Eosinophils | |
650 | 4 | |a Lung function | |
650 | 4 | |a Mepolizumab | |
650 | 4 | |a Severe asthma | |
700 | 1 | |a Brusselle, Guy |e verfasserin |4 aut | |
700 | 1 | |a Hanon, Shane |e verfasserin |4 aut | |
700 | 1 | |a Sohy, Carine |e verfasserin |4 aut | |
700 | 1 | |a Dupont, Lieven |e verfasserin |4 aut | |
700 | 1 | |a Peche, Rudy |e verfasserin |4 aut | |
700 | 1 | |a Michils, Alain |e verfasserin |4 aut | |
700 | 1 | |a Pilette, Charles |e verfasserin |4 aut | |
700 | 1 | |a Joos, Guy |e verfasserin |4 aut | |
700 | 1 | |a Lahousse, Lies |e verfasserin |4 aut | |
700 | 1 | |a Lapperre, Therese |e verfasserin |4 aut | |
700 | 1 | |a Louis, Renaud |e verfasserin |4 aut | |
700 | 1 | |a Schleich, Florence |e verfasserin |4 aut | |
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