Clinical characteristics and biological treatment responses of patients with late-onset asthma phenotype

Allergy and Asthma Proceedings, Journal Year: 2025, Volume and Issue: 46(2), P. 109 - 118

Published: Feb. 27, 2025

Background: The data on subphenotypes and treatment responses to biologicals in late-onset asthma (LOA) is limited. This study aims compare the clinical characteristics severe patients receiving biological treatments, categorized into early-onset (EOA) LOA groups. Methods: Patients treated with omalizumab or mepolizumab for at least six months a tertiary care adult allergy clinic between December 2015 2023 were included. persistent respiratory symptoms starting age ≥40 years as LOA, while those onset <40 EOA. Changes Asthma Control Questionnaire (ACQ-6) scores, forced expiratory volume one second (FEV1) percentages, blood eosinophil counts assessed baseline 6 months. percentage change FEV1 (liters) relative was measured. Clinical remission rates evaluated completing year of treatment. Results: Among 87 patients, 38 (43.7%) had 49 (56.3%) Of these, 22 (25.3%) received 65 (74.7%) mepolizumab, mean duration 24.7 (±19.7) higher obesity tobacco consumption compared EOA (p = 0.041 p 0.024, respectively). There no significant differences groups ACQ percentage, liters 0.531, 0.219, 0.632, 0.700, Within scores did not significantly differ 0.801). At months, decreased but 0.002). Conclusion: Biological similar Omalizumab showed comparable efficacy, exception count changes patients.

Language: Английский

Head‐To‐Head Comparison of Biologic Efficacy in Asthma: What Have We Learned?

Allergy, Journal Year: 2025, Volume and Issue: unknown

Published: March 29, 2025

We performed an in-depth appraisal of indirect head-to-head comparisons biologics approved for asthma, including anti-IL5/5Rα (mepolizumab, benralizumab), anti-IL4Rα (dupilumab), anti-TSLP (tezepelumab) and anti-IgE (omalizumab), which was neither a systematic review nor meta-analysis. A crude evaluation 95% CI's rate ratios excluded unity revealed greater overall reductions in annualised exacerbations with dupilumab versus either mepolizumab or benralizumab also tezepelumab benralizumab. Furthermore patients eosinophils ≥ 300/μL exacerbation rates were lower tezepelumab, benralizumab; eosinophils< 150/μL dupilumab. For lung function, no differences FEV1 response observed between drugs where there considerable heterogeneity overlapping CI's. Dupilumab superior to oscillometry-derived peripheral resistance compliance, as well attenuation mannitol airway hyperresponsiveness. There asthma control quality life scores the effect sizes small, along wide overlaps is unmet need prospective pragmatic randomised controlled trials directly compare biologics, especially assess clinical remission both type 2 high low patients. Real-life studies might evaluate complete different include outcomes such inhaled corticosteroid sparing, small airways dysfunction using oscillometry, abolition hyperresponsiveness mucus plugging remodelling wall thickening imaging.

Language: Английский

Combining Dual Biologics Therapy for Severe Asthma: A Series of Ten Cases

Journal of Asthma and Allergy, Journal Year: 2025, Volume and Issue: Volume 18, P. 507 - 517

Published: April 1, 2025

Biologic therapy has revolutionized the management of severe asthma, but a subset patients with asthma exhibits symptoms inadequately controlled by monotherapy, potentially due to involvement multi-type 2 pathways. Dual biologic emerged as promising strategy, its efficacy and safety are not yet fully understood. To describe characteristics, endotyping features, decision-making process therapeutic response on dual in real-world setting. We present ten biologics for asthma. The combinations include mepolizumab+ dupilumab (n=7), benralizumab+dupilumab (n=1), omazulab+mepolizumab (n=2). Therapeutic was assessed type inflammation biomarkers, symptom control, frequency acute exacerbations, daily oral corticosteroid (OCS) dosage side effects. In our 10 cases, six them women, mean age 56±15 years old. duration combination use 13.5 months (range from 4 36 months). initiated because inadequate control (N1, N2, N6), poor comorbidities (N5, N7, N8, N9) or anti-IL4/13R-induced hypereosinophilia (N3, N4, N5, N10) when treated single agent. All exhibited good tolerance combined therapies, leading improvements comorbidity management, reduction OCS usage. No serious adverse events were reported. have been shown be both effective safe. However, more studies needed assess long-term benefits potential risks different treatments.

Language: Английский