Smaller Differences in the Comparative Effectiveness of Biologics in Reducing Asthma-Related Hospitalizations Compared With Overall Exacerbations

Akenroye, Ayobami; Marshall, James; Simon, Andrew L.; Hague, Christian; Costa, Rebecca; Jamal-Allial, Aziza; McMahill-Walraven, Cheryl N.; Haffenreffer, Katie; Han, Amy; Wu, Ann Chen

doi:10.1016/j.jaip.2024.02.034

Cited by 2 publications

(3 citation statements)

References 30 publications

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“…В нашем исследовании, как и в других [27,28,34], в целом преобладали женщины (n = 69 vs мужчины n = 26). Но в подгруппе дупилумаба группы 2 60% составили мужчины.…”

Section: Discussionunclassified

“…Но не все показатели играют одинаковую роль. Обычно в исследованиях придают значение достижению контроля над астмой (по опросникам АСТ и/или ACQ (Asthma Control Questionnaire)), уменьшению дозы или полному отказу от СГКС, снижению частоты обострений БА, улучшению функции легких (ОФВ 1 ) [8,9,11,13,27,28,34,40,41]. Кроме того, эти показатели входят в оценку ремиссии ТБА [42] и разработанную K. Milger шкалу ответа на биологическую терапию при ТБА -BARS (Biologics Asthma Response Score) [43,44].…”

Section: Discussionunclassified

“…Таким образом, остается актуальной тема фенотипирования ТБА. В научных базах данных представлено не так много прямых сравнительных исследований, результаты которых неоднозначны, в т. ч. из-за сравнения препаратов, действующих на разные механизмы Т2-воспаления, у пациентов с разными фенотипами [27,28]. Поэтому мы провели прямое сравнительное исследование двух таргетных препаратов, действующих в рамках одного звена Т2-воспаления, в четко определенных фенотипических группах.…”

Section: Introductionunclassified

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Direct comparative study of anti-IgE and anti-IL4Rα therapy effectiveness in patients with severe allergic and mixed bronchial asthma

Naumova,

Beltyukov,

Kovtun

et al. 2024

Medicinskij sovet

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Introduction. There is insufficiency of direct comparative studies of genetically engineered biological drugs (GEBD) for severe bronchial asthma (SA) treatment in scientific databases.Aim. To compare omalizumab and dupilumab effectiveness in patients with allergic and mixed SA in real clinical practice.Materials and methods. The direct comparative study included SA patients with an allergic component from regional registry of Sverdlovsk region. The data of patients with allergic (n = 68) and mixed (n = 27) SA treated with omalizumab (n = 62) and dupilumab (n = 33) were analyzed. Therapy effectiveness was determined for 12 months in general group No. 1, allergic asthma group No. 2 and mixed asthma group No. 3 according to the following indicators: asthma control level (ACT), proportion of patients with uncontrolled asthma, need for systemic glucocorticosteroids (SGCS) and short‐acting beta agonists (SABA), basic therapy volume, asthma exacerbations number, emergency calls and hospitalizations, forced expiratory volume in the first second (FEV ), assessment of life quality (AQLQ and SNOT-22). Control evaluation visits were conducted before therapy start, after 4 and 12 months of biologics taking.Results. In general, during the 12 months of targeted therapy in patients receiving omalizumab statistically significant positive dynamics was observed in 12 of the 13 evaluated indicators; in patients receiving dupilumab – in 9 indicators. When analyzing such indicators as, ACT, taking SGCS, exacerbations of SA, FEV , statistically significant positive dynamics was revealed for all 4 indicators in patients receiving omalizumab in group No. 2 and in patients receiving dupilumab in group No. 3.Conclusions. Patients with allergic component of SA respond equally well to therapy with omalizumab and dupilumab. At the same time, a tendency towards the advantage of omalizumab in patients with allergic asthma, and dupilumab in patients with a mixed phenotype of the disease was revealed.

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Section: Discussionunclassified

Section: Introductionunclassified

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Direct comparative study of anti-IgE and anti-IL4Rα therapy effectiveness in patients with severe allergic and mixed bronchial asthma

Naumova,

Beltyukov,

Kovtun

et al. 2024

Medicinskij sovet

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Molecular Pathways and Potential Therapeutic Targets of Refractory Asthma

Ishmael,

Casale,

Cardet

2024

Biology

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Asthma is a chronic inflammatory lung disease. Refractory asthma poses a significant challenge in management due to its resistance to standard therapies. Key molecular pathways of refractory asthma include T2 inflammation mediated by Th2 and ILC2 cells, eosinophils, and cytokines including IL-4, IL-5, and IL-13. Additionally, non-T2 mechanisms involving neutrophils, macrophages, IL-1, IL-6, and IL-17 mediate a corticosteroid resistant phenotype. Mediators including alarmins (IL-25, IL-33, TSLP) and OX40L have overlap between T2 and non-T2 inflammation and may signify unique pathways of asthma inflammation. Therapies that target these pathways and mediators have proven to be effective in reducing exacerbations and improving lung function in subsets of severe asthma patients. However, there are patients with severe asthma who do not respond to approved therapies. Small molecule inhibitors, such as JAK-inhibitors, and monoclonal antibodies targeting mast cells, IL-1, IL-6, IL-33, TNFα, and OX40L are under investigation for their potential to modulate inflammation involved in refractory asthma. Understanding refractory asthma heterogeneity and identifying mediators involved are essential in developing therapeutic interventions for patients unresponsive to currently approved biologics. Further investigation is needed to develop personalized treatments based on these molecular insights to potentially offer more effective treatments for this complex disease.

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Smaller Differences in the Comparative Effectiveness of Biologics in Reducing Asthma-Related Hospitalizations Compared With Overall Exacerbations

Cited by 2 publications

References 30 publications

Direct comparative study of anti-IgE and anti-IL4Rα therapy effectiveness in patients with severe allergic and mixed bronchial asthma

Direct comparative study of anti-IgE and anti-IL4Rα therapy effectiveness in patients with severe allergic and mixed bronchial asthma

Molecular Pathways and Potential Therapeutic Targets of Refractory Asthma

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