Long-Term Weight Changes After Starting Anti–IL-5/5Ra Biologics in Severe Asthma: The Role of Oral Corticosteroids

Havé, L.; Visser, Edith; Meulmeester, Fleur L.; Nederveen-Bendien, S A van; Braunstahl, Gert‐Jan; Broeders, M.E.A.C.; Fieten, Karin B.; Hashimoto, Simone; Huisstede, Astrid van; Langeveld, Bas; Oud, Karen TM.; Patberg, Kornelis W.; Smeenk, Frank W.J.M.; Veen, Anneke van; Veen, Ilonka H. van; Ven, Marjo J.T. van de; Weersink, Els J.M.; Jong, Kim de; Sont, Jacob K.; Kroes, Johannes A.; Brinke, Anneke ten

doi:10.1016/j.jaip.2023.06.054

Cited by 6 publications

(3 citation statements)

References 27 publications

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“…Moreover, long-term weight reduction was associated with biologic therapy in patients with severe eosinophilic asthma, an effect that was attributed to reduced OCS use. The greatest weight loss was observed in patients that had the highest exposure to OCS before initiating biologic therapy combined with a reduction in OCS dose during treatment ( Ten Have et al, 2023 ). Therefore, biologic therapies could be particularly beneficial for OCS-treated asthma patients with obesity in mitigating both comorbid conditions.…”

Section: Asthma and Obesitymentioning

confidence: 99%

“…As mentioned above, biologic therapies influence long-term (2-year) weight loss through sparing of OCS, which contributes to weight gain as a side effect ( Ten Have et al, 2023 ). Significant weight loss following initiation of anti-IL-5 therapies in the short-term (6–11 months) has been reported, but these findings were not replicated in a separate study ( Kuruvilla et al, 2019b ; Cusack et al, 2021 ).…”

Section: Biological Therapies In Type-2 High Asthmamentioning

confidence: 99%

“…Significant weight loss following initiation of anti-IL-5 therapies in the short-term (6–11 months) has been reported, but these findings were not replicated in a separate study ( Kuruvilla et al, 2019b ; Cusack et al, 2021 ). Regardless, a subgroup of asthma patients has been identified that gained a significant amount of weight at the short- or long-term time points in the studies ( Kuruvilla et al, 2019b ; Cusack et al, 2021 ; Ten Have et al, 2023 ). The factors contributing to this weight gain in the subgroup are likely complex and postulated to be due to depletion of eosinophils by anti-IL-5-targeted biologics, influencing adipose tissue homeostasis and body weight ( Calco et al, 2020 ).…”

Section: Biological Therapies In Type-2 High Asthmamentioning

confidence: 99%

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Effects of biological therapies on patients with Type-2 high asthma and comorbid obesity

Garg,

Que,

Ingram

2024

Front. Pharmacol.

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Over 20 million adults and 6 million children in the United States (US) have asthma, a chronic respiratory disease characterized by airway inflammation, bronchoconstriction, and mucus hypersecretion. Obesity, another highly prevalent disease in the US, is a major risk factor for asthma and a significant cause of diminished asthma control, increased submucosal eosinophilia, and reduced quality of life. A large subgroup of these patients experiences severe symptoms and recurrent exacerbations despite maximal dosage of standard asthma therapies. In the past two decades, the development of biological therapies has revolutionized the field and advanced our understanding of type 2 inflammatory biomarkers. However, patients with obesity and comorbid asthma are not principally considered in clinical trials of biologics. Large landmark cluster analyses of patients with asthma have consistently identified specific asthma phenotypes that associate with obesity but may be differentiated by age of asthma onset and inflammatory cell profiles in sputum. These patterns suggest that biologic processes driving asthma pathology are heterogenous among patients with obesity. The biological mechanisms driving pathology in patients with asthma and comorbid obesity are not well understood and likely multifactorial. Future research needs to be done to elicit the cellular and metabolic functions in the relationship of obesity and asthma to yield the best treatment options for this multiplex condition. In this review, we explore the key features of type 2 inflammation in asthma and discuss the effectiveness, safety profile, and research gaps regarding the currently approved biological therapies in asthma patients with obesity.

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Section: Asthma and Obesitymentioning

confidence: 99%