Physical Activity as a New Tool to Evaluate the Response to Omalizumab and Mepolizumab in Severe Asthmatic Patients: A Pilot Study

Abstract

Asthma is a chronic inflammatory airway disease, representing one of the most severe pathologies in developed countries. Based on a report of the World Health Organization (WHO), it affects about 300 million people worldwide. Few studies have analyzed the effects of daily life physical activity (PA) levels in patients with asthma: moreover, little research has been carried out on PA levels in patients suffering from severe asthma (SA). This study aimed to investigate the PA levels in two groups of patients suffering from SA; in particular, this study analyzed the changes that occur in patients treated with biologic therapy (BT group) and patients who underwent traditional treatment (TT group) over 6 months. Moreover, this study represents a pilot study because, to the best of our knowledge, it is the first investigation that analyzed if the kind of biologic drug (omalizumab or mepolizumab) can produce differences in the PA levels of SA patients. Fifty SA patients were enrolled and PA parameters were monitored for 6 months. Subjects were divided into two treatment groups: TT (20 patients) and BT (30 patients), the BT group was further subdivided according to the drugs used (15, omalizumab; 15, mepolizumab). During drug treatment, all subjects improved their PA levels: indeed, considering the intragroup variation, the PA levels were significantly higher comparing the T6 levels to baseline (T0, p < 0.01). Considering the intragroup variation, it is very interesting to note that biologic therapy improved PA levels compared to the effects of traditional therapy; while at T0 there were no significant differences in the steps per day (SPD) values between the two groups (T0, p = 0.85), the differences become statistically significant at T1, T3, and T6 (T1, p = 0.019; T3, p = 3.48x10 −6 ; T6, p = 4.78x10 −10). As expected, the same differences were reported analyzing the energy expenditure data. In

Daily Physical Activity in Asthma and the Effect of Mepolizumab Therapy

“…To our knowledge, the present is the second study to investigate the effect of any asthma therapy on DPA. Carpagnano et al [ 39 ] found significant improvements in daily step count and energy expenditure in 30 patients treated with biological therapy (omalizumab or mepolizumab) for six months compared to patients on traditional therapy. The magnitude of improvement with biologic therapy was notably larger than in our study, as the patients almost doubled their daily steps (from 3806 ± 421 to 6545 ± 844) [ 39 ].…”

The Management of Extrapulmonary Comorbidities and Treatable Traits; Obesity, Physical Inactivity, Anxiety, and Depression, in Adults With Asthma

“…The effect of pharmacological therapies such as biologics on physical activity levels in asthma, however, is largely unknown. To our knowledge, Carpagnano and colleagues were the first to explore the effect of biologics on physical activity levels in severe asthma compared to traditional therapies ( 98 ). In this pilot study, published in 2020, fifty patients with severe asthma who were treated with either high-dose ICS with a LABA/LAMA and a biologic [omalizumab ( n = 15) or mepolizumab ( n = 15)], or traditional therapy (ICS/LABA/LAMA/OCS, n = 20) were followed over 6 months ( 98 ).…”

“…To our knowledge, Carpagnano and colleagues were the first to explore the effect of biologics on physical activity levels in severe asthma compared to traditional therapies ( 98 ). In this pilot study, published in 2020, fifty patients with severe asthma who were treated with either high-dose ICS with a LABA/LAMA and a biologic [omalizumab ( n = 15) or mepolizumab ( n = 15)], or traditional therapy (ICS/LABA/LAMA/OCS, n = 20) were followed over 6 months ( 98 ). While improvements in physical activity levels [average steps per day (SPD) and total daily energy expenditure (Total EE)] were observed both groups (biologic therapy and traditional therapy), a significantly greater increase in physical activity was reported in patients who received a biologic add-on therapy ( 98 ).…”

“…In this pilot study, published in 2020, fifty patients with severe asthma who were treated with either high-dose ICS with a LABA/LAMA and a biologic [omalizumab ( n = 15) or mepolizumab ( n = 15)], or traditional therapy (ICS/LABA/LAMA/OCS, n = 20) were followed over 6 months ( 98 ). While improvements in physical activity levels [average steps per day (SPD) and total daily energy expenditure (Total EE)] were observed both groups (biologic therapy and traditional therapy), a significantly greater increase in physical activity was reported in patients who received a biologic add-on therapy ( 98 ). No significant differences in physical activity levels were reported in patients who were received omalizumab compared to mepolizumab, with both biologics found to have comparable positive effects.…”

The beneficial effects of physical activity and weight loss on human colorectal carcinoma cell lines

“…A correct nutrition, adequate physical activity and abstention from smoking are important measures against aging and prevention of cardiovascular disease and cancer (Larsen et al, 2019). Data literature reported that physical activity reduces or slows the onset of diseases related to obesity, inducing a considerable weight loss and having beneficial and anti-inflammatory effects, reducing the production of free radicals, and favouring greater resistance to stress and prolonging lifespan (Carpagnano et al, 2020). Furthermore, a healthy lifestyle induces the expression of a many genes involved in the repair of cellular damage and reduces the expression of genes involved in the mechanisms of oxidative stress and inflammation (Nigro 2016).…”