Predictors of Early and Late Lung Function Improvement in Severe Eosinophilic Asthma on Type2-Biologics in the PRISM Study.

IF 4.6 2区 医学 Q1 RESPIRATORY SYSTEM Lung Pub Date : 2024-02-01 Epub Date: 2024-01-22 DOI:10.1007/s00408-024-00670-w
Duong Duc Pham, Ji-Hyang Lee, Hyouk-Soo Kwon, Woo-Jung Song, You Sook Cho, Hyunkyoung Kim, Jae-Woo Kwon, So-Young Park, Sujeong Kim, Gyu Young Hur, Byung Keun Kim, Young-Hee Nam, Min-Suk Yang, Mi-Yeong Kim, Sae-Hoon Kim, Byung-Jae Lee, Taehoon Lee, So-Young Park, Min-Hye Kim, Young-Joo Cho, ChanSun Park, Jae-Woo Jung, Han Ki Park, Joo-Hee Kim, Ji-Yong Moon, Pankaj Bhavsar, Ian Adcock, Kian Fan Chung, Tae-Bum Kim
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Abstract

Background: The determinants linked to the short- and long-term improvement in lung function in patients with severe eosinophilic asthma (SEA) on biological treatment (BioT) remain elusive.

Objective: We sought to identify the predictors of early and late lung function improvement in patients with SEA after BioT.

Methods: 140 adult patients with SEA who received mepolizumab, dupilumab, or reslizumab were followed up for 6 months to evaluate improvement in forced expiratory volume in one second (FEV1). Logistic regression was used to determine the association between potential prognostic factors and improved lung function at 1 and 6 months of treatment.

Results: More than a third of patients with SEA using BioT showed early and sustained improvements in FEV1 after 1 month. A significant association was found between low baseline FEV1 and high blood eosinophil count and sustained FEV1 improvement after 1 month (0.54 [0.37-0.79] and 1.88 [1.28-2.97] odds ratios and 95% confidence interval, respectively). Meanwhile, among patients who did not experience FEV1 improvement after 1 month, 39% exhibited improvement at 6 months follow-up. A high ACT score measured at this visit was the most reliable predictor of late response after 6 months of treatment (OR and 95% CI 1.75 [1.09-2.98]).

Conclusion: Factors predicting the efficacy of biological agents that improve lung function in SEA vary according to the stage of response.

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PRISM 研究中使用 2 型生物制剂的严重嗜酸性粒细胞性哮喘患者早期和晚期肺功能改善的预测因素
背景:严重嗜酸性粒细胞性哮喘(SEA)患者接受生物治疗(BioT)后肺功能短期和长期改善的决定性因素仍然难以确定:方法:对 140 名接受过麦波利珠单抗、杜匹单抗或瑞斯利珠单抗治疗的成人嗜酸性粒细胞性哮喘患者进行为期 6 个月的随访,以评估患者一秒钟用力呼气容积(FEV1)的改善情况。采用逻辑回归法确定潜在预后因素与治疗 1 个月和 6 个月肺功能改善之间的关系:超过三分之一的 SEA 患者在使用 BioT 治疗 1 个月后,FEV1 出现了早期和持续的改善。低基线 FEV1 和高血液嗜酸性粒细胞计数与 1 个月后 FEV1 的持续改善之间存在明显关联(几率比和 95% 置信区间分别为 0.54 [0.37-0.79] 和 1.88 [1.28-2.97])。同时,在 1 个月后 FEV1 没有改善的患者中,有 39% 的患者在 6 个月的随访中表现出了改善。在这次随访中测得的高ACT评分是预测治疗6个月后晚期反应的最可靠因素(OR和95% CI 1.75 [1.09-2.98]):结论:预测改善 SEA 肺功能的生物制剂疗效的因素因反应阶段而异。
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来源期刊
Lung
Lung 医学-呼吸系统
CiteScore
9.10
自引率
10.00%
发文量
95
审稿时长
6-12 weeks
期刊介绍: Lung publishes original articles, reviews and editorials on all aspects of the healthy and diseased lungs, of the airways, and of breathing. Epidemiological, clinical, pathophysiological, biochemical, and pharmacological studies fall within the scope of the journal. Case reports, short communications and technical notes can be accepted if they are of particular interest.
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