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

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 (FEV.sub.1). 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 FEV.sub.1 after 1 month. A significant association was found between low baseline FEV.sub.1 and high blood eosinophil count and sustained FEV.sub.1 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 FEV.sub.1 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.
Author(s): Duong Duc Pham [sup.1], Ji-Hyang Lee [sup.1], Hyouk-Soo Kwon [sup.1], Woo-Jung Song [sup.1], You Sook Cho [sup.1], Hyunkyoung Kim [sup.1], Jae-Woo Kwon [sup.2], So-Young Park [sup.3], Sujeong Kim [sup.4], [...]