Clinical remission in severe asthma with biologic therapy : an analysis from the UK Severe Asthma Registry
Copyright ©The authors 2023..
BACKGROUND: Novel biologic therapies have revolutionised the management of severe asthma with more ambitious treatment aims. Here we analyse the definition of clinical remission as a suggested treatment goal and consider the characteristics associated with clinical remission in a large, real-world severe asthma cohort.
METHODS: This was a retrospective analysis of severe asthma patients registered in the UK Severe Asthma Registry (UKSAR) who met strict national access criteria for biologics. Patients had a pre-biologics baseline assessment and annual review. The primary definition of clinical remission applied included Asthma Control Questionnaire (ACQ)-5 <1.5 and no oral corticosteroids for disease control and forced expiratory volume in 1 s above lower limit of normal or no more than 100 mL less than baseline.
RESULTS: 18.3% of patients achieved the primary definition of remission. The adjusted odds of remission on biologic therapy were 7.44 (95% CI 1.73-31.95)-fold higher in patients with type 2 (T2)-high biomarkers. The adjusted odds of remission were lower in patients who were female (OR 0.61, 95% CI 0.45-0.93), obese (OR 0.49, 95% CI 0.24-0.65) or had ACQ-5 ≥1.5 (OR 0.19, 95% CI 0.12-0.31) pre-biologic therapy. The likelihood of remission reduced by 14% (95% CI 0.76-0.97) for every 10-year increase in disease duration. 12-21% of the cohort attained clinical remission depending on the definition applied; most of those who did not achieve remission failed to meet multiple criteria.
CONCLUSIONS: 18.3% of patients achieved the primary definition of clinical remission. Remission was more likely in T2-high biomarker patients with shorter duration of disease and less comorbidity. Further research on the optimum time to commence biologics in severe asthma is required.
| Errataetall: |
CommentIn: Eur Respir J. 2023 Dec 14;62(6):. - PMID 38097202 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:62 |
|---|---|
| Enthalten in: |
The European respiratory journal - 62(2023), 6 vom: 04. Dez. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
McDowell, P Jane [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Anti-Asthmatic Agents |
|---|
| Anmerkungen: |
Date Completed 16.12.2023 Date Revised 09.01.2024 published: Electronic-Print CommentIn: Eur Respir J. 2023 Dec 14;62(6):. - PMID 38097202 Citation Status MEDLINE |
|---|
| doi: |
10.1183/13993003.00819-2023 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM363498591 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM363498591 | ||
| 003 | DE-627 | ||
| 005 | 20240114233003.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1183/13993003.00819-2023 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1253.xml |
| 035 | |a (DE-627)NLM363498591 | ||
| 035 | |a (NLM)37857423 | ||
| 035 | |a (PII)2300819 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a McDowell, P Jane |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Clinical remission in severe asthma with biologic therapy |b an analysis from the UK Severe Asthma Registry |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 16.12.2023 | ||
| 500 | |a Date Revised 09.01.2024 | ||
| 500 | |a published: Electronic-Print | ||
| 500 | |a CommentIn: Eur Respir J. 2023 Dec 14;62(6):. - PMID 38097202 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright ©The authors 2023. | ||
| 520 | |a BACKGROUND: Novel biologic therapies have revolutionised the management of severe asthma with more ambitious treatment aims. Here we analyse the definition of clinical remission as a suggested treatment goal and consider the characteristics associated with clinical remission in a large, real-world severe asthma cohort | ||
| 520 | |a METHODS: This was a retrospective analysis of severe asthma patients registered in the UK Severe Asthma Registry (UKSAR) who met strict national access criteria for biologics. Patients had a pre-biologics baseline assessment and annual review. The primary definition of clinical remission applied included Asthma Control Questionnaire (ACQ)-5 <1.5 and no oral corticosteroids for disease control and forced expiratory volume in 1 s above lower limit of normal or no more than 100 mL less than baseline | ||
| 520 | |a RESULTS: 18.3% of patients achieved the primary definition of remission. The adjusted odds of remission on biologic therapy were 7.44 (95% CI 1.73-31.95)-fold higher in patients with type 2 (T2)-high biomarkers. The adjusted odds of remission were lower in patients who were female (OR 0.61, 95% CI 0.45-0.93), obese (OR 0.49, 95% CI 0.24-0.65) or had ACQ-5 ≥1.5 (OR 0.19, 95% CI 0.12-0.31) pre-biologic therapy. The likelihood of remission reduced by 14% (95% CI 0.76-0.97) for every 10-year increase in disease duration. 12-21% of the cohort attained clinical remission depending on the definition applied; most of those who did not achieve remission failed to meet multiple criteria | ||
| 520 | |a CONCLUSIONS: 18.3% of patients achieved the primary definition of clinical remission. Remission was more likely in T2-high biomarker patients with shorter duration of disease and less comorbidity. Further research on the optimum time to commence biologics in severe asthma is required | ||
| 650 | 4 | |a Journal Article | |
| 650 | 7 | |a Biomarkers |2 NLM | |
| 650 | 7 | |a Biological Products |2 NLM | |
| 650 | 7 | |a Anti-Asthmatic Agents |2 NLM | |
| 700 | 1 | |a McDowell, Ron |e verfasserin |4 aut | |
| 700 | 1 | |a Busby, John |e verfasserin |4 aut | |
| 700 | 1 | |a Eastwood, M Chad |e verfasserin |4 aut | |
| 700 | 1 | |a Patel, Pujan H |e verfasserin |4 aut | |
| 700 | 1 | |a Jackson, David J |e verfasserin |4 aut | |
| 700 | 1 | |a Mansur, Adel |e verfasserin |4 aut | |
| 700 | 1 | |a Patel, Mitesh |e verfasserin |4 aut | |
| 700 | 1 | |a Burhan, Hassan |e verfasserin |4 aut | |
| 700 | 1 | |a Doe, Simon |e verfasserin |4 aut | |
| 700 | 1 | |a Chaudhuri, Rekha |e verfasserin |4 aut | |
| 700 | 1 | |a Gore, Robin |e verfasserin |4 aut | |
| 700 | 1 | |a Dodd, James W |e verfasserin |4 aut | |
| 700 | 1 | |a Subramanian, Deepak |e verfasserin |4 aut | |
| 700 | 1 | |a Brown, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Heaney, Liam G |e verfasserin |4 aut | |
| 700 | 0 | |a UK Severe Asthma Registry |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The European respiratory journal |d 1989 |g 62(2023), 6 vom: 04. Dez. |w (DE-627)NLM012664782 |x 0903-1936 |7 nnns |
| 773 | 1 | 8 | |g volume:62 |g year:2023 |g number:6 |g day:04 |g month:12 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1183/13993003.00819-2023 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 62 |j 2023 |e 6 |b 04 |c 12 | ||