Predictors of Early and Late Lung Function Improvement in Severe Eosinophilic Asthma on Type2-Biologics in the PRISM Study

Duong Duc Pham, Ji Hyang Lee, Hyouk Soo Kwon, Woo Jung Song, You Sook Cho, Hyunkyoung Kim, Jae Woo Kwon, So Young Park, Sujeong Kim, Gyu Young Hur, Byung Keun Kim, Young Hee Nam, Min Suk Yang, Mi Yeong Kim, Sae Hoon Kim, Byung Jae Lee, Taehoon Lee, So Young Park, Min Hye Kim, Young Joo ChoChan Sun Park, Jae Woo Jung, Han Ki Park, Joo Hee Kim, Ji Yong Moon, Pankaj Bhavsar, Ian Adcock, Kian Fan Chung, Tae Bum Kim

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The determinants linked to the short- and long-term improvement in lung function in patients with severe eosinophilic asthma (SEA) on biological treatment (BioT) remain elusive. Objective: We sought to identify the predictors of early and late lung function improvement in patients with SEA after BioT. Methods: 140 adult patients with SEA who received mepolizumab, dupilumab, or reslizumab were followed up for 6 months to evaluate improvement in forced expiratory volume in one second (FEV1). Logistic regression was used to determine the association between potential prognostic factors and improved lung function at 1 and 6 months of treatment. Results: More than a third of patients with SEA using BioT showed early and sustained improvements in FEV1 after 1 month. A significant association was found between low baseline FEV1 and high blood eosinophil count and sustained FEV1 improvement after 1 month (0.54 [0.37–0.79] and 1.88 [1.28–2.97] odds ratios and 95% confidence interval, respectively). Meanwhile, among patients who did not experience FEV1 improvement after 1 month, 39% exhibited improvement at 6 months follow-up. A high ACT score measured at this visit was the most reliable predictor of late response after 6 months of treatment (OR and 95% CI 1.75 [1.09–2.98]). Conclusion: Factors predicting the efficacy of biological agents that improve lung function in SEA vary according to the stage of response.

Original languageEnglish
Pages (from-to)41-51
Number of pages11
JournalLung
Volume202
Issue number1
DOIs
StatePublished - Feb 2024

Bibliographical note

Publisher Copyright:
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.

Keywords

  • Biologics
  • Early and late response
  • Lung function
  • Severe eosinophilic asthma

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