Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/33600
Title: Biologics (mepolizumab and omalizumab) induced remission in severe asthma patients.
Austin Authors: Thomas, Dennis;McDonald, Vanessa M;Stevens, Sean ;Harvey, Erin S;Baraket, Melissa;Bardin, Philip;Bowden, Jeffrey J;Bowler, Simon;Chien, Jimmy;Chung, Li Ping;Gillman, Andrew;Hew, Mark;Hodge, Sandra;James, Alan;Jenkins, Christine;Katelaris, Constance H;Katsoulotos, Gregory P;Langton, David;Lee, Joy ;Marks, Guy;Peters, Matthew;Radhakrishna, Naghmeh;Reynolds, Paul N;Rimmer, Janet;Sivakumaran, Pathmanathan;Upham, John W;Wark, Peter;Yang, Ian A;Gibson, Peter G
Affiliation: Centre of Excellence in Treatable Traits, College of Health, Medicine and Wellbeing, University of Newcastle, Hunter Medical Research Institute Asthma and Breathing Programme, Newcastle, New South Wales, Australia.
Centre of Excellence in Treatable Traits, College of Health, Medicine and Wellbeing, University of Newcastle, Hunter Medical Research Institute Asthma and Breathing Programme, Newcastle, New South Wales, Australia.;Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia.
South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia.;Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.
Lung and Sleep Medicine, Monash University and Medical Centre and Hudson Institute, Clayton, Victoria, Australia.
Respiratory and Sleep Services, Flinders Medical Centre and Flinders University, Bedford Park, South Australia, Australia.
Department of Respiratory Medicine, Mater Hospital, Brisbane, Queensland, Australia.
Department of Sleep and Respiratory Medicine, Westmead Hospital, Westmead, New South Wales, Australia.;School of Medicine, The University of Sydney, Sydney, New South Wales, Australia.
Department of Respiratory Medicine, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
Allergy, Asthma and Clinical Immunology, Alfred Health, Melbourne, Victoria, Australia.;School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Lung Research Laboratory, Hanson Institute, Adelaide, South Australia, Australia.;Department of Thoracic Medicine, Royal Adelaide Hospital, Lung Research, University of Adelaide, Adelaide, South Australia, Australia.
Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.;Medcial School, The University of Western Australia, Perth, Western Australia, Australia.
Department of Thoracic Medicine, Concord Hospital, Concord, New South Wales, Australia.;Concord Clinical School, University of Sydney, Concord, New South Wales, Australia.
School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia.;Immunology and Allergy Unit, Campbelltown Hospital, Campbelltown, New South Wales, Australia.
Woolcock Institute of Medical Research, University of Sydney, Glebe, New South Wales, Australia.;The University of Notre Dame, Sydney, Western Australia, Australia.;St George Specialist Centre, Kogarah, New South Wales, Australia.;St Vincent's Clinic, Darlinghurst, New South Wales, Australia.
Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia.;Department of Thoracic Medicine, Frankston Hospital, Frankston, Victoria, Australia.
Austin Health
South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia.;Woolcock Institute of Medical Research, University of Sydney, Glebe, New South Wales, Australia.
Department of Thoracic Medicine, Concord Hospital, Concord, New South Wales, Australia.
Respiratory Department, St Vincent's Hospital, Melbourne, Victoria, Australia.
Department of Thoracic Medicine, Royal Adelaide Hospital, Lung Research, University of Adelaide, Adelaide, South Australia, Australia.
Woolcock Institute of Medical Research, University of Sydney, Glebe, New South Wales, Australia.;St Vincent's Clinic, Darlinghurst, New South Wales, Australia.
Department of Respiratory Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia.
Department of Respiratory Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia.;Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
Centre of Excellence in Treatable Traits, College of Health, Medicine and Wellbeing, University of Newcastle, Hunter Medical Research Institute Asthma and Breathing Programme, Newcastle, New South Wales, Australia.;Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia.
Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.;Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Queensland, Australia.
Centre of Excellence in Treatable Traits, College of Health, Medicine and Wellbeing, University of Newcastle, Hunter Medical Research Institute Asthma and Breathing Programme, Newcastle, New South Wales, Australia.;Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia.
Issue Date: Feb-2024
Date: 2023
Publication information: Allergy 2024-02; 79(2)
Abstract: Asthma remission has emerged as a potential treatment goal. This study evaluated the effectiveness of two biologics (mepolizumab/omalizumab) in achieving asthma remission. This observational study included 453 severe asthma patients (41% male; mean age ± SD 55.7 ± 14.7 years) from two real-world drug registries: the Australian Mepolizumab Registry and the Australian Xolair Registry. The composite outcome clinical remission was defined as zero exacerbations and zero oral corticosteroids during the previous 6 months assessed at 12 months and 5-item Asthma Control Questionnaire (ACQ-5) ≤1 at 12 months. We also assessed clinical remission plus optimization (post-bronchodilator FEV1 ≥80%) or stabilization (post-bronchodilator FEV1 not greater than 5% decline from baseline) of lung function at 12 months. Sensitivity analyses explored various cut-offs of ACQ-5/FEV1 scores. The predictors of clinical remission were identified. 29.3% (73/249) of AMR and 22.8% (37/162) of AXR cohort met the criteria for clinical remission. When lung function criteria were added, the remission rates were reduced to 25.2% and 19.1%, respectively. Sensitivity analyses identified that the remission rate ranged between 18.1% and 34.9% in the AMR cohort and 10.6% and 27.2% in the AXR cohort. Better lung function, lower body mass index, mild disease and absence of comorbidities such as obesity, depression and osteoporosis predicted the odds of achieving clinical remission. Biologic treatment with mepolizumab or omalizumab for severe asthma-induced asthma remission in a subgroup of patients. Remission on treatment may be an achievable treatment target and future studies should consider remission as an outcome measure.
URI: https://ahro.austin.org.au/austinjspui/handle/1/33600
DOI: 10.1111/all.15867
ORCID: 0000-0003-4182-6821
0000-0002-7498-0000
0000-0002-9401-298X
0000-0002-9881-9895
0000-0001-6014-2367
0000-0002-0017-3433
Journal: Allergy
PubMed URL: 37632144
ISSN: 1398-9995
Type: Journal Article
Subjects: asthma
mepolizumab
omalizumab
remission
Appears in Collections:Journal articles

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