Long-term therapy response to anti-interleukin-5 biologics in severe asthma - a real-life evaluation.
J Allergy Clin Immunol Pract. 2020 Oct 15;:
Authors: Eger K, Kroes JA, Ten Brinke A, Bel EH
Abstract
BACKGROUND: Patients with severe eosinophilic asthma show different responses to various anti-interleukin (IL)-5 biologics, ranging from super- to non-response. Residual disease manifestations observed in partial responders may prompt physicians to switch between biologics. More data on response, switches, and residual disease manifestations are needed to improve personalized treatment.
OBJECTIVE: To assess; (1) prevalences and predictors of super-, partial- and non-responders to long-term anti-IL-5 treatment, (2) frequency and reasons for switches between anti-IL-5 biologics, (3) nature of residual disease manifestations.
METHODS: In this 2-years follow-up study, severe asthma patients were included who initiated an anti-IL-5 biologic (mepolizumab, reslizumab, benralizumab) (n=114). Patient characteristics (clinical, functional, inflammatory) and co-morbidities were collected at baseline and 2-years follow-up.
DEFINITIONS: "super-responders" showed no residual disease manifestations at 2-years follow-up; "partial responders" experienced residual disease manifestations, and "non-responders" discontinued anti-IL-5 treatment <2yr because of clinical worsening.
RESULT: s: After 2-years anti-IL-5 treatment 14% of patients were super responders, 69% partial responders, and 11% non-responders. Super-response was predicted by shorter asthma duration and higher FEV1, and tended to be associated with adult-onset asthma, absence of nasal polyps and lower BMI. Switches between anti-IL-5 biologics occurred frequently (41%). After 2-years treatment most common residual disease manifestations included impaired lung function (59%), uncontrolled sino-nasal disease (58%) and uncontrolled asthma symptoms (48%).
CONCLUSION: After 2 years of anti-IL-5 treatment, a favorable response was found in 83% of severe asthma patients, including a super-response in 14%. Most partial responders show impaired lung function or uncontrolled sino-nasal disease, causing physicians to switch between biologics.
PMID: 33069885 [PubMed - as supplied by publisher]
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