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Real-life biomarker response to anti-IL5 and anti-IgE therapies in severe asthma patients

S Burkill, C M. Porsbjerg, A Bourdin, T N Tran, N Martin, R Katial, P Barker, M E Wechsler, J Maspero, S Bosnic-Anticevich, L P Chung, G Katsoulotos, G C Christoff, T A Popov, M Sadatsafavi, C A Torres-Duque, C Ulrik, K Dahl Assing, S Hansen, A Altraja, L A Lehtimaki, N G Papadopoulos, K Kostikas, S Salvi, R W Costello, P Francesca, T Iwanaga, C K Rhee, M Al-Ahmad, D Larenas-Linnemann, J A Fonseca, R Amaral, K Alving, R Al-Lehebi, L Perez De-Llano, B Kirenga, M Tsai, B Mahboub, P E Pfeffer, W Henley, Y Liu, J Lyu, C Goh, T Uthaman, D Price, J Townend
European Respiratory Journal 2022 60: 3305; DOI: 10.1183/13993003.congress-2022.3305
S Burkill
1Observational and Pragmatic Research Institute, Singapore, Singapore
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C M. Porsbjerg
2Respiratory Research Unit, Copenhagen University Hospital, Bispebjerg, Denmark
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A Bourdin
3PhyMedExp, Univ Montpellier, CNRS, INSERM, CHU Montpellier, Montpellier, France
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T N Tran
4AstraZeneca, Gaithersburg, USA
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N Martin
4AstraZeneca, Gaithersburg, USA
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R Katial
4AstraZeneca, Gaithersburg, USA
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P Barker
4AstraZeneca, Gaithersburg, USA
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M E Wechsler
5NJH Cohen Family Asthma Institute, Department of Medicine, National Jewish Health, Denver, USA
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J Maspero
6Clinical Research for Allergy and Respiratory Medicine, CIDEA Foundation, Buenos Aires, Argentina
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S Bosnic-Anticevich
7Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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L P Chung
8Fiona Stanley Hospital, Perth, Australia
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G Katsoulotos
9Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
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G C Christoff
10Medical University-Sofia, Faculty of Public Health, Sofia, Bulgaria
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T A Popov
11University Hospital "Sv. Ivan Rilski", Sofia, Bulgaria
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M Sadatsafavi
12Respiratory Evaluation Sciences Program, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
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C A Torres-Duque
13INEUMO, Research Center, Fundación Neumológica Colombiana, Bogotá, Colombia
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C Ulrik
14Respiratory Research Unit, Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Hvidovre, Denmark
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K Dahl Assing
15Department of Respiratory Medicine, Aalborg University Hospital, Aalborg, Denmark
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S Hansen
16Respiratory Research Unit, Bispebjerg University Hospital, Copenhagen, Denmark
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A Altraja
17Department of Pulmonology, University of Tartu and Lung Clinic, Tartu University Hospital, Tartu, Estonia
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L A Lehtimaki
18Allergy Centre, Tampere University Hospital, Tampere, Finland
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N G Papadopoulos
19Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
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K Kostikas
20Respiratory Medicine Department, University of Ioannina, Ioannina, Greece
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S Salvi
21Pulmocare Research and Education Foundation, Pune, India
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R W Costello
22Clinical Research Centre, Smurfit Building Beaumont Hospital, Department of Respiratory Medicine, RCSI, Dublin, Ireland
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P Francesca
23Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy
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T Iwanaga
24Center for General Medical Education and Clinical Training, Kindai University Hospital, Osakasayama, Japan
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C K Rhee
25Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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M Al-Ahmad
26Microbiology Department, Faculty of Medicine, Kuwait University, Al-Rashed Allergy Center, Ministry of Health, Kuwait, Kuwait
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D Larenas-Linnemann
27Centro de Excelencia en Asma y Alergia, Hospital Médica Sur, Ciudad de México, Mexico
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J A Fonseca
28Health Information and Decision Sciences Department (MEDCIDS) & Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine of University of Porto, Porto, Portugal
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R Amaral
29Department of Women's and Children's Health, Uppsala University, Sweden, Sweden
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K Alving
29Department of Women's and Children's Health, Uppsala University, Sweden, Sweden
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R Al-Lehebi
30Department of Pulmonology, King Fahad Medical City, Riyadh, Saudi Arabia
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L Perez De-Llano
31Pneumology Service, Lucus Augusti University Hospital, EOXI Lugo, Monforte, Cervo, Italy
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B Kirenga
32Makerere University Lung Institute, Kampala, Uganda
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M Tsai
33Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan, Taiwan
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B Mahboub
34College of Medicine, University of Sharjah, Sharjah, Utd.Arab Emir.
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P E Pfeffer
35Department of Respiratory Medicine, Barts Health NHS Trust, London, United Kingdom
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W Henley
1Observational and Pragmatic Research Institute, Singapore, Singapore
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Y Liu
36Consulting, Strategy AI & Transformation, Deloitte, Brisbane, Australia
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J Lyu
1Observational and Pragmatic Research Institute, Singapore, Singapore
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C Goh
1Observational and Pragmatic Research Institute, Singapore, Singapore
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T Uthaman
1Observational and Pragmatic Research Institute, Singapore, Singapore
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D Price
1Observational and Pragmatic Research Institute, Singapore, Singapore
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J Townend
37Norwich, United Kingdom
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Abstract

Introduction/Background: Biologics (Bx) are known to decrease specific biomarker levels: anti-IL5 reduces blood eosinophils (BEC) and anti-IgE slightly reduces FeNO. Anti-IL5 and anti-IgE are thought to have limited effect on total IgE (IgE).

Aims and Objectives: To assess the proportions of severe asthma patients whose biomarkers (BEC, FeNO, and serum IgE) decrease following anti-IL5 and anti-IgE initiation.

Methods: Patients in the International Severe Asthma Registry (ISAR) with biomarker and Bx data were included. From pre-Bx baseline to the post-Bx time period, the median (IQR) change in biomarker level and the proportion of patients with >25% decrease in biomarkers were determined.

Results: At 2-3 years from Bx initiation, BEC decreased by >25% in 80.7% of anti-IL5 and 41.6% of anti-IgE patients. FeNO decreased by >25% in 41.6% of anti-IL5 and 47.8% of anti-IgE patients. IgE decreased by >25% in 41.7% of anti-IL5 and 15.6% of anti-IgE patients (Figure).

Figure: Median (IQR) biomarker changes and patient proportions with decreased biomarkers in response to Bx.

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Conclusions: Anti-IL5 was superior in decreasing BEC and both Bx classes decreased FeNO to a limited extent. The lower proportion of anti-IgE patients with IgE reduction could be attributed to serum total IgE (not free IgE) measurement. Apart from anti-IL5’s effect on BEC, <50% patients had decreased biomarkers; the clinical implications should be explored.

  • Severe asthma
  • Biomarkers
  • Treatments

Footnotes

Cite this article as Eur Respir J 2022; 60: Suppl. 66, 3305.

This article was presented at the 2022 ERS International Congress, in session “-”.

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 2022
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Real-life biomarker response to anti-IL5 and anti-IgE therapies in severe asthma patients
S Burkill, C M. Porsbjerg, A Bourdin, T N Tran, N Martin, R Katial, P Barker, M E Wechsler, J Maspero, S Bosnic-Anticevich, L P Chung, G Katsoulotos, G C Christoff, T A Popov, M Sadatsafavi, C A Torres-Duque, C Ulrik, K Dahl Assing, S Hansen, A Altraja, L A Lehtimaki, N G Papadopoulos, K Kostikas, S Salvi, R W Costello, P Francesca, T Iwanaga, C K Rhee, M Al-Ahmad, D Larenas-Linnemann, J A Fonseca, R Amaral, K Alving, R Al-Lehebi, L Perez De-Llano, B Kirenga, M Tsai, B Mahboub, P E Pfeffer, W Henley, Y Liu, J Lyu, C Goh, T Uthaman, D Price, J Townend
European Respiratory Journal Sep 2022, 60 (suppl 66) 3305; DOI: 10.1183/13993003.congress-2022.3305

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Real-life biomarker response to anti-IL5 and anti-IgE therapies in severe asthma patients
S Burkill, C M. Porsbjerg, A Bourdin, T N Tran, N Martin, R Katial, P Barker, M E Wechsler, J Maspero, S Bosnic-Anticevich, L P Chung, G Katsoulotos, G C Christoff, T A Popov, M Sadatsafavi, C A Torres-Duque, C Ulrik, K Dahl Assing, S Hansen, A Altraja, L A Lehtimaki, N G Papadopoulos, K Kostikas, S Salvi, R W Costello, P Francesca, T Iwanaga, C K Rhee, M Al-Ahmad, D Larenas-Linnemann, J A Fonseca, R Amaral, K Alving, R Al-Lehebi, L Perez De-Llano, B Kirenga, M Tsai, B Mahboub, P E Pfeffer, W Henley, Y Liu, J Lyu, C Goh, T Uthaman, D Price, J Townend
European Respiratory Journal Sep 2022, 60 (suppl 66) 3305; DOI: 10.1183/13993003.congress-2022.3305
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