[en] [en] BACKGROUND: Nasal polyposis (NP) is a comorbidity of type 2 severe asthma (SA) which could influence response to SA biologics.
METHODS: We evaluated (super-) response in SA patients with (NP +) and without NP (NP-) enrolled in the Belgian Severe Asthma Registry (BSAR).
RESULTS: 914 patients, of whom 31% NP + , were included. At enrollment, NP + patients had higher annual exacerbation rates, higher number of emergency room visits and more elevated type 2 biomarkers. In the longitudinal subanalysis of 104 patients, both groups had significant and similar asthma responses to asthma biologics, except for a greater increase in FEV1 in the NP + group. Super-response was achieved in 33 patients (32%), irrespective of NP status or type of biologic.
CONCLUSION: In conclusion, both NP + and NP - patients had positive treatment responses, with some able to achieve super-response. In SA patients with NP, a greater FEV1 improvement as compared to SA patients without NP was observed.
Schleich, Florence ; Université de Liège - ULiège > Département des Sciences de l'activité physique et de la réadaptation
Louis, Renaud ; Université de Liège - ULiège > Département des sciences cliniques > Pneumologie - Allergologie
Brusselle, Guy; Department of Respiratory Medicine, Ghent University Hospital, 9000, Ghent, Belgium
Sohy, Carine; Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur (Site Godinne), Université Catholique de Louvain, Yvoir, Belgium
Michils, Alain; Chest Department, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
Pilette, Charles; Pneumology Department, Cliniques Universitaires Saint-Luc, and Institute of Experimental and Clinical Research (IREC), UCLouvain, 1200, Brussels, Belgium
G.W. Canonica L. Malvezzi F. Blasi et al. Chronic rhinosinusitis with nasal polyps impact in severe asthma patients: evidences from the Severe Asthma Network Italy (SANI) registry Respir Med 2020 166 105947 10.1016/j.rmed.2020.105947 32250875
G.G. Brusselle G.H. Koppelman Biologic therapies for severe asthma N Engl J Med 2022 386 2 157 171 1:CAS:528:DC%2BB38XhvV2gtr8%3D 10.1056/NEJMra2032506 35020986
F. Schleich C. Moermans L. Seidel et al. Benralizumab in severe eosinophilic asthma in real life: confirmed effectiveness and contrasted effect on sputum eosinophilia versus exhaled nitric oxide fraction - PROMISE ERJ Open Res 2023 9 6 00383 2023 10.1183/23120541.00383-2023 38020567 10680030
A. Wautlet C. Bachert M. Desrosiers P.W. Hellings A.T. Peters The management of chronic rhinosinusitis with nasal polyps (CRSwNP) with biologics J Allergy Clin Immunol Pract 2023 11 9 2642 2651 1:CAS:528:DC%2BB3sXht1KmsbjP 10.1016/j.jaip.2023.04.054 37182568
P. Kolkhir C.A. Akdis M. Akdis et al. Type 2 chronic inflammatory diseases: targets, therapies and unmet needs Nat Rev Drug Discov 2023 22 9 743 767 1:CAS:528:DC%2BB3sXhs1SnsL7I 10.1038/s41573-023-00750-1 37528191
M.E. Wechsler G. Scelo D.E.S. Larenas-Linnemann et al. Association between T2-related comorbidities and effectiveness of biologics in severe asthma Am J Respir Crit Care Med 2024 209 3 262 272 1:CAS:528:DC%2BB2cXptlygur8%3D 10.1164/rccm.202305-0808OC 38016003
S. Cottin V. Doyen C. Pilette Upper airway disease diagnosis as a predictive biomarker of therapeutic response to biologics in severe asthma Front Med (Lausanne) 2023 10 1129300 10.3389/fmed.2023.1129300 37035303
J.W. Upham C. Le Lievre D.J. Jackson et al. Defining a severe asthma super-responder: findings from a delphi process J Allergy Clin Immunol Pract 2021 9 11 3997 4004 10.1016/j.jaip.2021.06.041 34271216
J.E. Kavanagh G. d'Ancona M. Elstad et al. Real-world effectiveness and the characteristics of a "Super-Responder" to mepolizumab in severe eosinophilic asthma Chest 2020 158 2 491 500 1:CAS:528:DC%2BB3cXhtlWmtrzF 10.1016/j.chest.2020.03.042 32275980
S. Gerday S. Graff C. Moermans et al. Super-responders to anti-IL-5/anti-IL-5R are characterised by high sputum eosinophil counts at baseline Thorax 2023 78 11 1138 1141 10.1136/thorax-2022-219781 37657926
Global Initiative for Asthma (2023) Global Strategy for Asthma Management and Prevention. www.ginasthma.org. Accessed 5 Apr 2024.
Chung KF, Wenzel SE, Brozek JL, et al. (2014) International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma Eur Respir J 43(2):343–373. https://doi.org/10.1183/09031936.00202013
R.A. Nathan C.A. Sorkness M. Kosinski et al. Development of the asthma control test: a survey for assessing asthma control J Allergy Clin Immunol 2004 113 1 59 65 10.1016/j.jaci.2003.09.008 14713908
E.F. Juniper P.M. O'Byrne G.H. Guyatt P.J. Ferrie D.R. King Development and validation of a questionnaire to measure asthma control Eur Respir J 1999 14 4 902 907 1:STN:280:DC%2BD3c%2Fjsl2isw%3D%3D 10.1034/j.1399-3003.1999.14d29.x 10573240
E.F. Juniper G.H. Guyatt A. Willan L.E. Griffith Determining a minimal important change in a disease-specific Quality of Life Questionnaire J Clin Epidemiol 1994 47 1 81 87 1:STN:280:DyaK2c7htVyjsA%3D%3D 10.1016/0895-4356(94)90036-1 8283197
M. Maniscalco C. Calabrese M. D'Amato et al. Association between exhaled nitric oxide and nasal polyposis in severe asthma Respir Med 2019 152 20 24 10.1016/j.rmed.2019.04.017 31128605
P.G. Gibson C.M. Prazma G.L. Chupp et al. Mepolizumab improves clinical outcomes in patients with severe asthma and comorbid conditions Respir Res 2021 22 1 171 1:CAS:528:DC%2BB3MXhsFSgu7jL 10.1186/s12931-021-01746-4 34098955 8182929
