Comparative effectiveness of anti-IL5 and anti-IgE biologic classes in patients with severe asthma eligible for both
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Comparative effectiveness of anti-IL5 and anti-IgE biologic classes in patients with severe asthma eligible for both. / Pfeffer, Paul E.; Ali, Nasloon; Murray, Ruth; Ulrik, Charlotte; Tran, Trung N.; Maspero, Jorge; Peters, Matthew; Christoff, George C.; Sadatsafavi, Mohsen; Torres-Duque, Carlos A.; Altraja, Alan; Lehtimäki, Lauri; Papadopoulos, Nikolaos G; Salvi, Sundeep; Costello, Richard W.; Cushen, Breda; Heffler, Enrico; Iwanaga, Takashi; Al-Ahmad, Mona; Larenas-Linnemann, Désirée; Kuna, Piotr; Fonseca, João A.; Al-Lehebi, Riyad; Rhee, Chin Kook; Perez-de-Llano, Luis; Perng Steve, Diahn Warng; Mahboub, Bassam; Wang, Eileen; Goh, Celine; Lyu, Juntao; Newell, Anthony; Alacqua, Marianna; Belevskiy, Andrey S.; Bhutani, Mohit; Bjermer, Leif; Bjornsdottir, Unnur; Bourdin, Arnaud; Bulow, Anna von; Busby, John; Canonica, Giorgio Walter; Cosio, Borja G.; Dorscheid, Delbert R.; Muñoz-Esquerre, Mariana; FitzGerald, J. Mark; Gil, Esther Garcia; Gibson, Peter G.; Heaney, Liam G.; Hew, Mark; Hilberg, Ole; Hoyte, Flavia; Jackson, David J.; Koh, Mariko Siyue; Ko, Hsin Kuo Bruce; Lee, Jae Ha; Lehmann, Sverre; Chaves Loureiro, Cláudia; Lúðvíksdóttir, Dóra; Menzies-Gow, Andrew N.; Mitchell, Patrick; Papaioannou, Andriana I.; Popov, Todor A.; Porsbjerg, Celeste M.; Salameh, Laila; Sirena, Concetta; Taillé, Camille; Taube, Christian; Tohda, Yuji; Wechsler, Michael E.; Price, David B.
In: Allergy: European Journal of Allergy and Clinical Immunology, Vol. 78, No. 7, 2023, p. 1934-1948.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Comparative effectiveness of anti-IL5 and anti-IgE biologic classes in patients with severe asthma eligible for both
AU - Pfeffer, Paul E.
AU - Ali, Nasloon
AU - Murray, Ruth
AU - Ulrik, Charlotte
AU - Tran, Trung N.
AU - Maspero, Jorge
AU - Peters, Matthew
AU - Christoff, George C.
AU - Sadatsafavi, Mohsen
AU - Torres-Duque, Carlos A.
AU - Altraja, Alan
AU - Lehtimäki, Lauri
AU - Papadopoulos, Nikolaos G
AU - Salvi, Sundeep
AU - Costello, Richard W.
AU - Cushen, Breda
AU - Heffler, Enrico
AU - Iwanaga, Takashi
AU - Al-Ahmad, Mona
AU - Larenas-Linnemann, Désirée
AU - Kuna, Piotr
AU - Fonseca, João A.
AU - Al-Lehebi, Riyad
AU - Rhee, Chin Kook
AU - Perez-de-Llano, Luis
AU - Perng Steve, Diahn Warng
AU - Mahboub, Bassam
AU - Wang, Eileen
AU - Goh, Celine
AU - Lyu, Juntao
AU - Newell, Anthony
AU - Alacqua, Marianna
AU - Belevskiy, Andrey S.
AU - Bhutani, Mohit
AU - Bjermer, Leif
AU - Bjornsdottir, Unnur
AU - Bourdin, Arnaud
AU - Bulow, Anna von
AU - Busby, John
AU - Canonica, Giorgio Walter
AU - Cosio, Borja G.
AU - Dorscheid, Delbert R.
AU - Muñoz-Esquerre, Mariana
AU - FitzGerald, J. Mark
AU - Gil, Esther Garcia
AU - Gibson, Peter G.
AU - Heaney, Liam G.
AU - Hew, Mark
AU - Hilberg, Ole
AU - Hoyte, Flavia
AU - Jackson, David J.
AU - Koh, Mariko Siyue
AU - Ko, Hsin Kuo Bruce
AU - Lee, Jae Ha
AU - Lehmann, Sverre
AU - Chaves Loureiro, Cláudia
AU - Lúðvíksdóttir, Dóra
AU - Menzies-Gow, Andrew N.
AU - Mitchell, Patrick
AU - Papaioannou, Andriana I.
AU - Popov, Todor A.
AU - Porsbjerg, Celeste M.
AU - Salameh, Laila
AU - Sirena, Concetta
AU - Taillé, Camille
AU - Taube, Christian
AU - Tohda, Yuji
AU - Wechsler, Michael E.
AU - Price, David B.
N1 - Publisher Copyright: © 2023 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.
PY - 2023
Y1 - 2023
N2 - Background: Patients with severe asthma may present with characteristics representing overlapping phenotypes, making them eligible for more than one class of biologic. Our aim was to describe the profile of adult patients with severe asthma eligible for both anti-IgE and anti-IL5/5R and to compare the effectiveness of both classes of treatment in real life. Methods: This was a prospective cohort study that included adult patients with severe asthma from 22 countries enrolled into the International Severe Asthma registry (ISAR) who were eligible for both anti-IgE and anti-IL5/5R. The effectiveness of anti-IgE and anti-IL5/5R was compared in a 1:1 matched cohort. Exacerbation rate was the primary effectiveness endpoint. Secondary endpoints included long-term-oral corticosteroid (LTOCS) use, asthma-related emergency room (ER) attendance, and hospital admissions. Results: In the matched analysis (n = 350/group), the mean annualized exacerbation rate decreased by 47.1% in the anti-IL5/5R group and 38.7% in the anti-IgE group. Patients treated with anti-IL5/5R were less likely to experience a future exacerbation (adjusted IRR 0.76; 95% CI 0.64, 0.89; p < 0.001) and experienced a greater reduction in mean LTOCS dose than those treated with anti-IgE (37.44% vs. 20.55% reduction; p = 0.023). There was some evidence to suggest that patients treated with anti-IL5/5R experienced fewer asthma-related hospitalizations (IRR 0.64; 95% CI 0.38, 1.08), but not ER visits (IRR 0.94, 95% CI 0.61, 1.43). Conclusions: In real life, both anti-IgE and anti-IL5/5R improve asthma outcomes in patients eligible for both biologic classes; however, anti-IL5/5R was superior in terms of reducing asthma exacerbations and LTOCS use.
AB - Background: Patients with severe asthma may present with characteristics representing overlapping phenotypes, making them eligible for more than one class of biologic. Our aim was to describe the profile of adult patients with severe asthma eligible for both anti-IgE and anti-IL5/5R and to compare the effectiveness of both classes of treatment in real life. Methods: This was a prospective cohort study that included adult patients with severe asthma from 22 countries enrolled into the International Severe Asthma registry (ISAR) who were eligible for both anti-IgE and anti-IL5/5R. The effectiveness of anti-IgE and anti-IL5/5R was compared in a 1:1 matched cohort. Exacerbation rate was the primary effectiveness endpoint. Secondary endpoints included long-term-oral corticosteroid (LTOCS) use, asthma-related emergency room (ER) attendance, and hospital admissions. Results: In the matched analysis (n = 350/group), the mean annualized exacerbation rate decreased by 47.1% in the anti-IL5/5R group and 38.7% in the anti-IgE group. Patients treated with anti-IL5/5R were less likely to experience a future exacerbation (adjusted IRR 0.76; 95% CI 0.64, 0.89; p < 0.001) and experienced a greater reduction in mean LTOCS dose than those treated with anti-IgE (37.44% vs. 20.55% reduction; p = 0.023). There was some evidence to suggest that patients treated with anti-IL5/5R experienced fewer asthma-related hospitalizations (IRR 0.64; 95% CI 0.38, 1.08), but not ER visits (IRR 0.94, 95% CI 0.61, 1.43). Conclusions: In real life, both anti-IgE and anti-IL5/5R improve asthma outcomes in patients eligible for both biologic classes; however, anti-IL5/5R was superior in terms of reducing asthma exacerbations and LTOCS use.
KW - biologics
KW - exacerbation
KW - ISAR
KW - oral corticosteroids
KW - real life
U2 - 10.1111/all.15711
DO - 10.1111/all.15711
M3 - Journal article
C2 - 36929509
AN - SCOPUS:85151412409
VL - 78
SP - 1934
EP - 1948
JO - Allergy: European Journal of Allergy and Clinical Immunology
JF - Allergy: European Journal of Allergy and Clinical Immunology
SN - 0105-4538
IS - 7
ER -
ID: 359798854