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The effectiveness of anti-IL5 biologics is comparable in previous-smokers and never-smokers with severe asthma

Susanne Hansen, Charlotte Ulrik, Ole Hilberg, Anna Von Bülow, Anders Christiansen, Claus R Johnsen, Johannes Schmid, Anne Sofie Bjerrum, Karin Assing, Alexandra Wimmer-Aune, Niels Krogh, Linda Rasmussen, Celeste Porsbjerg
European Respiratory Journal 2021 58: PA3742; DOI: 10.1183/13993003.congress-2021.PA3742
Susanne Hansen
1Bispebjerg Hospital, Copenhagen, Denmark
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  • For correspondence: Susanne.Hansen.10@regionh.dk
Charlotte Ulrik
2Hvidovre Hospital, Hvidovre, Denmark
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Ole Hilberg
3Vejle Hospital, Vejle, Denmark
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Anna Von Bülow
1Bispebjerg Hospital, Copenhagen, Denmark
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Anders Christiansen
4Odense University Hospital, Odense, Denmark
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Claus R Johnsen
5Gentofte Hospital, Gentofte, Denmark
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Johannes Schmid
6Aarhus University Hospital, Aarhus, Denmark
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Anne Sofie Bjerrum
6Aarhus University Hospital, Aarhus, Denmark
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Karin Assing
7Aalborg University Hospital, Aalborg, Denmark
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Alexandra Wimmer-Aune
7Aalborg University Hospital, Aalborg, Denmark
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Niels Krogh
8Zitelab ApS, Copenhagen, Denmark
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Linda Rasmussen
5Gentofte Hospital, Gentofte, Denmark
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Celeste Porsbjerg
1Bispebjerg Hospital, Copenhagen, Denmark
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Abstract

Background: Anti-IL5/anti-IL5-receptor treatment for severe asthma has demonstrated to be effective in randomized controlled trials. However, such trials do not include patients with a significant smoking history, and little is known about the effectiveness in previous smokers.

Objective: To assess whether previous smoking modifies the effectiveness of anti-IL5/anti-IL5 receptor treatment.

Methods: Patients in the Danish Severe Asthma Register treated with mepolizumab, reslizumab or benralizumab for at least 12 months were included. Percent change in the number of exacerbations and forced expiratory volume in the 1st second of predicted value (FEV1%) and change in mean Asthma Control Questionnaire (ACQ) score from baseline to 12 months were analyzed as continuous variables, adjusting for smoking status, age and sex.

Results: At start of treatment, 132 (44%) were previous smokers with a mean (standard deviation) packyears of 19 (15.6) years and 171 (56%) were never-smokers. After one year of treatment, the number of exacerbations was reduced by 68% (95% confidence interval (CI):55-80) in never-smokers and 54% (43-64) in previous smokers, p=0.10. ACQ score improved with -1.06 (-1.40, -0.72) in previous smokers and -1.03 (-1.37, -0.68) in never-smokers, p=0.91, and FEV1% increased by 13% (7-19) in previous smokers and 11% (4-18) in never-smokers, p=0.63.

Conclusion: In a nationwide cohort of patients with severe asthma, the effectiveness of anti-IL5/anti-Il5 receptor treatment was comparable in previous smokers and never-smokers, suggesting that a significant smoking history does not preclude a clinical effect of biological therapy.

  • Treatments
  • Asthma
  • Smoking

Footnotes

Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3742.

This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2021
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The effectiveness of anti-IL5 biologics is comparable in previous-smokers and never-smokers with severe asthma
Susanne Hansen, Charlotte Ulrik, Ole Hilberg, Anna Von Bülow, Anders Christiansen, Claus R Johnsen, Johannes Schmid, Anne Sofie Bjerrum, Karin Assing, Alexandra Wimmer-Aune, Niels Krogh, Linda Rasmussen, Celeste Porsbjerg
European Respiratory Journal Sep 2021, 58 (suppl 65) PA3742; DOI: 10.1183/13993003.congress-2021.PA3742

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The effectiveness of anti-IL5 biologics is comparable in previous-smokers and never-smokers with severe asthma
Susanne Hansen, Charlotte Ulrik, Ole Hilberg, Anna Von Bülow, Anders Christiansen, Claus R Johnsen, Johannes Schmid, Anne Sofie Bjerrum, Karin Assing, Alexandra Wimmer-Aune, Niels Krogh, Linda Rasmussen, Celeste Porsbjerg
European Respiratory Journal Sep 2021, 58 (suppl 65) PA3742; DOI: 10.1183/13993003.congress-2021.PA3742
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