Eosinophilic chronic rhinosinusitis as a predictor of super-responder and clinical remission in patients with uncontrolled type 2-high severe asthma treated with biologics

Abstract

Identifying which biomarkers and comorbidities of type 2 (T2) inflammation to focus on when selecting biologics has remained challenging. We retrospectively examined which biomarkers and comorbidities could influence asthma control among T2-high severe asthma patients receiving biologics. Patients without any maintenance oral corticosteroids and exacerbations requiring systemic corticosteroids indicated super-responder (SR). Clinical remission (CR) was defined as fulfilling the following criteria in addition to achieving SR: asthma symptom improvement (asthma control test score ≥23) and pulmonary function improvement (%forced expiratory volume in 1 s ≥ 80%). We initiated and switched biologics to achieve SR and CR. In total, 111 patients were evaluated, among whom 85.6% and 27.0%–50.5% demonstrated SR and CR, respectively. CR was more frequently observed among patients with severe eosinophilic chronic rhinosinusitis (ECRS) than among those without it. Attention must be paid to the existence of severe ECRS to achieve CR in patients with uncontrolled T2-high severe asthma.