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A comparison of treatment response to biologics in asthma-COPD overlap and pure asthma: Findings from the PRISM study

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Abstract
Background: Despite the increasing use of biologics in severe asthma, there is limited research on their use in asthma-chronic obstructive pulmonary disease overlap (ACO). We compared real-world treatment responses to biologics in ACO and asthma.

Methods: We conducted a multicenter, retrospective, cohort study using data from the Precision Medicine Intervention in Severe Asthma (PRISM). ACO was defined as post-bronchodilator forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) <0.7 and a smoking history of >10 pack-years. Physicians selected biologics (omalizumab, mepolizumab, reslizumab, benralizumab, and dupilumab) based on each United States Food & Drug Administration (FDA) approval criteria.

Results: After six-month treatment with biologics, both patients with ACO (N = 13) and asthma (N = 81) showed positive responses in FEV1 (10.69 ± 17.17 vs. 11.25 ± 12.87 %, P = 0.652), Asthma Control Test score (3.33 ± 5.47 vs. 5.39 ± 5.42, P = 0.290), oral corticosteroid use (-117.50 ± 94.38 vs. -115.06 ± 456.85 mg, P = 0.688), fractional exhaled nitric oxide levels (-18.62 ± 24.68 vs. -14.66 ± 45.35 ppb, P = 0.415), sputum eosinophils (-3.40 ± 10.60 vs. -14.48 ± 24.01 %, P = 0.065), blood eosinophils (-36.47 ± 517.02 vs. -363.22 ± 1294.59, P = 0.013), and exacerbation frequency (-3.07 ± 4.42 vs. -3.19 ± 5.11, P = 0.943). The odds ratio for exacerbation and time-to-first exacerbation showed no significant difference after full adjustments, and subgroup analysis according to biologic type was also showed similar results.

Conclusions: Biologics treatment response patterns in patients with ACO and asthma were comparable, suggesting that biologics should be actively considered for ACO patients as well.
Issued Date
2023
Ji-Su Shim
Hyunkyoung Kim
Jae-Woo Kwon
So-Young Park
Sujeong Kim
Byung-Keun Kim
Young-Hee Nam
Min-Suk Yang
Mi-Yeong Kim
Sae-Hoon Kim
Byung-Jae Lee
Taehoon Lee
Sang-Ha Kim
So Young Park
Young-Joo Cho
Chan Sun Park
Jae-Woo Jung
Han-Ki Park
Joo-Hee Kim
Jeong-Hee Choi
Ji-Yong Moon
Ian Adcock
Kian Fan Chung
Min-Hye Kim
Tae-Bum Kim
Type
Article
Keyword
AsthmaAsthma-COPD overlapBiologicsMonoclonal antibodiesTreatment response
DOI
10.1016/j.waojou.2023.100848
URI
https://oak.ulsan.ac.kr/handle/2021.oak/16419
Publisher
World Allergy Organization Journal
Language
한국어
ISSN
1939-4551
Citation Volume
16
Citation Number
12
Citation Start Page
1
Citation End Page
15
Appears in Collections:
Medicine > Nursing
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