Anti-Interleukin-5 Therapy Is Associated with Attenuated Lung Function Decline in Severe Eosinophilic Asthma Patients From the Belgian Severe Asthma Registry.
GRAFF, Sophie; Brusselle, Guy; Hanon, Shaneet al.
2022 • In Journal of Allergy and Clinical Immunology: In Practice, 10 (2), p. 467-477
[en] BACKGROUND: Asthmatics have accelerated lung function decline over time compared with healthy individuals.
OBJECTIVE: To evaluate risk factors for accelerated lung function decline.
METHODS: In a longitudinal analysis on severe asthmatics enrolled in the Belgian Severe Asthma Registry with at least 2 visits a minimum of 12 months apart, we compared characteristics of patients with and without decline (loss of post-bronchodilation forced expiratory volume in 1 s [FEV1] (% predicted)/y greater than zero) over time. Multiple linear regression was applied to study the factors independently associated with FEV1 decline.
RESULTS: In the overall population (n = 318), median annual FEV1 decline was 0.27 (-4.22 to 3.80) % predicted/y over a period of 23 months (12-41 months). Asthma was less controlled at baseline in nondecliners than in decliners (53%). Lung function and residual volume at baseline were higher in the declining group. Decliners presented with increased bronchial reactivity (ie, a lower provocative concentration of methacholine causing a 20% fall in FEV1) at baseline. Twenty-five percent of nondecliners were started on anti-interleukin-5 (anti-IL-5) for severe eosinophilic asthma during the study compared with 10% of decliners. The multivariable model suggested that Asthma Control Questionnaire score at baseline, late-onset asthma, and addition of anti-IL-5 during follow-up were associated with lower FEV1 decline, independently from other variables such as evolution in exacerbations, smoking status, inhaled corticosteroids or oral corticosteroids dose, or add-on anti-immunoglobulin E over time, whereas reversibility to salbutamol and higher FEV1 were associated with accelerated FEV1 decline.
CONCLUSIONS: Add-on therapy with anti-IL-5 in severe eosinophilic asthma was associated with an attenuated FEV1 decline. The causality of this observation should, however, be confirmed in future prospective controlled studies.
Sohy, Carine; Department of Respiratory Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
Dupont, Lieven; Department of Respiratory Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
Peche, Rudy; Department of Respiratory Medicine, CHU-Charleroi, A. Vésale Hospital, Charleroi, Belgium
Michils, Alain; Chest Department, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
Pilette, Charles; Cliniques Universitaires St.-Luc and Institute of Experimental and Clinical Research, Université Catholique de Louvain, Brussels, Belgium
Joos, Guy; Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
Lahousse, Lies; Department of Bioanalysis, Ghent University, Ghent, Belgium
Lapperre, Therese; Department of Pulmonary Medicine, Antwerp University and University Hospital Antwerp, Antwerp, Belgium
LOUIS, Renaud ; Centre Hospitalier Universitaire de Liège - CHU > > Service de pneumologie - allergologie
SCHLEICH, FLorence ; Centre Hospitalier Universitaire de Liège - CHU > > Service de pneumologie - allergologie
Anti-Interleukin-5 Therapy Is Associated with Attenuated Lung Function Decline in Severe Eosinophilic Asthma Patients From the Belgian Severe Asthma Registry.
Publication date :
2022
Journal title :
Journal of Allergy and Clinical Immunology: In Practice
ISSN :
2213-2198
eISSN :
2213-2201
Publisher :
American Academy of Allergy, Asthma and Immunology, United States
Conflicts of interest: G. Brusselle has, within the last 5 years, received honoraria for lectures from AstraZeneca, Boehringer-Ingelheim, Chiesi, GlaxoSmithKline, Novartis, and Teva; and is a member of advisory boards for Amgen, AstraZeneca, Boehringer-Ingelheim, Chiesi, GlaxoSmithKline, Novartis, Sanofi/Regeneron, and Teva. S. Hanon reports personal fees from GSK, AstraZeneca, Teva, Sanofi, and Novartis; and grants and personal fees from Chiesi , outside the submitted work. A. Michils reports grants, personal fees, and other from AstraZeneca ; grants, personal fees, and other from Chiesi ; grants and personal fees from GSK ; personal fees from Novartis, outside the submitted work. C. Pilette reports grants and personal fees from AstraZeneca, GSK, Chiesi, and Teva, outside the submitted work. G. Joos reports grants from AstraZeneca ; personal fees from Bayer; grants from Chiesi ; personal fees from Eureca VZW; grants and personal fees from GlaxoSmithKline ; and personal fees from Teva, outside the submitted work; all fees were paid to the department. T. Lapperre reports personal fees from GSK, AstraZeneca, Novartis, Boehringer Ingelheim and Chiesi, outside the submitted work. R. Louis reports grants and personal fees from GSK ; grants and personal fees from AstraZeneca ; grants and personal fees from Novartis ; and grants from Chiesi , outside the submitted work. F. Schleich reports grants and personal fees from GSK ; grants from AstraZeneca ; and grants and personal fees from Chiesi , outside the submitted work. The rest of the authors declare that they have no relevant conflicts of interest.This work was supported by the European Union (Interreg EMR Meuse Rhine 5a), Interuniversity Attraction Poles Program (IUAP), Belgian Science Policy (P7/30) and Federal Grant EOS (excellence of science) (number 30565447).Conflicts of interest: G. Brusselle has, within the last 5 years, received honoraria for lectures from AstraZeneca, Boehringer-Ingelheim, Chiesi, GlaxoSmithKline, Novartis, and Teva; and is a member of advisory boards for Amgen, AstraZeneca, Boehringer-Ingelheim, Chiesi, GlaxoSmithKline, Novartis, Sanofi/Regeneron, and Teva. S. Hanon reports personal fees from GSK, AstraZeneca, Teva, Sanofi, and Novartis; and grants and personal fees from Chiesi, outside the submitted work. A. Michils reports grants, personal fees, and other from AstraZeneca; grants, personal fees, and other from Chiesi; grants and personal fees from GSK; personal fees from Novartis, outside the submitted work. C. Pilette reports grants and personal fees from AstraZeneca, GSK, Chiesi, and Teva, outside the submitted work. G. Joos reports grants from AstraZeneca; personal fees from Bayer; grants from Chiesi; personal fees from Eureca VZW; grants and personal fees from GlaxoSmithKline; and personal fees from Teva, outside the submitted work; all fees were paid to the department. T. Lapperre reports personal fees from GSK, AstraZeneca, Novartis, Boehringer Ingelheim and Chiesi, outside the submitted work. R. Louis reports grants and personal fees from GSK; grants and personal fees from AstraZeneca; grants and personal fees from Novartis; and grants from Chiesi, outside the submitted work. F. Schleich reports grants and personal fees from GSK; grants from AstraZeneca; and grants and personal fees from Chiesi, outside the submitted work. The rest of the authors declare that they have no relevant conflicts of interest.This work was supported by the European Union (Interreg EMR Meuse Rhine 5a), Interuniversity Attraction Poles Program (IUAP), Belgian Science Policy (P7/30) and Federal Grant EOS (excellence of science) (number 30565447).
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