Association between pre-biologic T2-biomarker combinations and response to biologics in patients with severe asthma

• DOI: 10.3389/fimmu.2024.1361891
• Publication Date: 2024-04-19T04:23:55Z
• Authors: Celeste M. Porsbjerg; John Townend; Celine Bergeron; George C. Christoff; Gregory P. Katsou...; Désirée Larenas-L...; Trung N. Tran; Riyad Al-Lehebi; Sinthia Z. Bosnic...; John Busby; Mark Hew; Konstantinos Kost...; Nikolaos G. Papad...; Paul E. Pfeffer; Todor A. Popov; Chin Kook Rhee; Mohsen Sadatsafavi; Ming-Ju Tsai; Charlotte Suppli ...; Mona Al-Ahmad; Alan Altraja; Aaron Beastall; Lakmini Bulathsin...; Victoria Carter; Borja G. Cosio; Kirsty Fletton; Susanne Hansen; Liam G. Heaney; Richard B. Hubbard; Piotr Kuna; Ruth B. Murray; Tatsuya Nagano; Laura Pini; Diana Jimena Cano...; Florence Schleich; Michael E. Wechsler; Rita Amaral; Arnaud Bourdin; Guy G. Brusselle; Wenjia Chen; Li Ping Chung; Eve Denton; Joao A. Fonseca; Flavia Hoyte; David J. Jackson; Rohit Katial; Bruce J. Kirenga; Mariko Siyue Koh; Agnieszka Ławkiedraj; Lauri Lehtimäki; Mei Fong Liew; Bassam Mahboub; Neil Martin; Andrew N. Menzies...; Pee Hwee Pang; Andriana I. Papai...; Pujan H. Patel; Luis Perez-De-Llano; Matthew J. Peters; Luisa Ricciardi; Bellanid Rodrígue...; Ivan Solarte; Tunn Ren Tay; Carlos A. Torres-...; Eileen Wang; Martina Zappa; John Abisheganaden; Karin Dahl Assing; Richard W. Costello; Peter G. Gibson; Enrico Heffler; Jorge Máspero; Stefania Nicola; Diahn-Warng Perng...; Francesca Puggioni; Sundeep Salvi; Chau-Chyun Sheu; Concetta Sirena; Camille Taillé; Tze Lee Tan; Leif Bjermer; Giorgio Walter Ca...; Takashi Iwanaga; Libardo Jiménez-M...; Christian Taube; Luisa Brussino; David B. Price
• Keywords: Association (psychology); Inflammatory response

Background To date, studies investigating the association between pre-biologic biomarker levels and post-biologic outcomes have been limited to single biomarkers assessment of biologic efficacy from structured clinical trials. Aim elucidate associations individual or their combinations with pre-to-post changes in asthma real-life. Methods This was a registry-based, cohort study using data 23 countries, which shared International Severe Asthma Registry (May 2017-February 2023). The investigated (highest levels) were immunoglobulin E (IgE), blood eosinophil count (BEC) fractional exhaled nitric oxide (FeNO). Pre- approximately 12-month change for each three outcome domains (i.e. exacerbation rate, symptom control lung function), this combined biomarkers. Results Overall, 3751 patients initiated biologics included analysis. No found BEC rate any class. However, higher FeNO both associated greater improvement FEV 1 anti-IgE anti-IL5/5R, trend anti-IL4Rα. Mean improved by 27-178 mL post-anti-IgE as increased (250 1000 cells/µL), 43-216 129-250 post-anti-IL5/5R -anti-IL4Rα, respectively along same gradient. Corresponding improvements gradient (25-100 ppb) 41-274 mL, 69-207 148-224 anti-IgE, anti-IL4Rα, respectively. Higher baseline also lower probability uncontrolled (OR 0.392; p=0.001) anti-IL5/5R. Pre-biologic IgE poor predictor subsequent pre-to-post-biologic all assessed biologics. combination + marginally prediction increase (adjusted R 2 : 0.751), compared 0.747) alone 0.743) (p=0.005 <0.001, respectively); however, not addition IgE. Conclusions ability BEC, predict biologic-associated function may encourage earlier intervention impaired at risk accelerated decline.