Clinical response and remission in severe asthma patients treated with biologic therapies

Susanne Hansen; Marianne Søndergaard; Anna von Bülow; Anne-Sofie Bjerrum; Johannes Schmid; Linda M Rasmussen; Claus R Johnsen; Truls Ingebrigtsen; Kjell Erik Julius Håkansson; Sofie Lock Johansson; Maria Bisgaard; Karin Dahl Assing; Ole Hilberg; Charlotte Ulrik; Celeste Porsbjerg

doi:10.1016/j.chest.2023.10.046

Clinical response and remission in severe asthma patients treated with biologic therapies

Susanne Hansen, Marianne Søndergaard, Anna von Bülow, Anne-Sofie Bjerrum, Johannes Schmid, Linda M Rasmussen, Claus R Johnsen, Truls Ingebrigtsen, Kjell Erik Julius Håkansson, Sofie Lock Johansson, Maria Bisgaard, Karin Dahl Assing, Ole Hilberg, Charlotte Ulrik, Celeste Porsbjerg

Abstract

BACKGROUND: The development of novel targeted biologic therapies for severe asthma has provided an opportunity to consider remission as a new treatment goal.

RESEARCH QUESTION: How many severe asthma patients treated with biologic therapy achieve clinical remission, and what predicts response to treatment?

STUDY DESIGN AND METHODS: The Danish Severe Asthma Registry is a nationwide register including all adult patients receiving biologic therapy for severe asthma in Denmark. We conducted an observational cohort study and defined "clinical response" to treatment after 12 months as ≥50% reduction in exacerbations, and/or a ≥50% reduction in maintenance oral corticosteroid dose, if required. "Clinical remission" was defined by cessation of exacerbations and maintenance OCS, as well as a normalization of lung function (FEV1%>80%) and an Asthma Control Questionnaire-6 score ≤1.50 after 12 months of treatment.

RESULTS: After 12 months of treatment of 501 biologically naïve patients, there were 104 (21%) patients with no response to treatment, whereas 397 (79%) had a clinical response. Among the latter, 97 (24%) fulfilled our criteria of clinical remission, corresponding to 19% in the entire population. Remission was predicted by shorter duration of disease and lower BMI in our entire population of all patients treated with biologic therapy.

INTERPRETATION: Clinical response was achieved in most adult patients initiating biologic therapy and clinical remission was observed in 19% of the patients after 12 months of treatment. Further studies are required to assess the long-term outcome of achieving clinical remission on biologic therapy.

Original language	English
Journal	Chest
ISSN	0012-3692
DOIs	https://doi.org/10.1016/j.chest.2023.10.046
Publication status	E-pub ahead of print - 2 Nov 2023

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Hansen, S., Søndergaard, M., von Bülow, A., Bjerrum, A-S., Schmid, J., Rasmussen, L. M., Johnsen, C. R., Ingebrigtsen, T., Julius Håkansson, K. E., Johansson, S. L., Bisgaard, M., Assing, K. D., Hilberg, O., Ulrik, C., & Porsbjerg, C. (2023). Clinical response and remission in severe asthma patients treated with biologic therapies. Chest. https://doi.org/10.1016/j.chest.2023.10.046

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title = "Clinical response and remission in severe asthma patients treated with biologic therapies",

abstract = "BACKGROUND: The development of novel targeted biologic therapies for severe asthma has provided an opportunity to consider remission as a new treatment goal.RESEARCH QUESTION: How many severe asthma patients treated with biologic therapy achieve clinical remission, and what predicts response to treatment?STUDY DESIGN AND METHODS: The Danish Severe Asthma Registry is a nationwide register including all adult patients receiving biologic therapy for severe asthma in Denmark. We conducted an observational cohort study and defined {"}clinical response{"} to treatment after 12 months as ≥50% reduction in exacerbations, and/or a ≥50% reduction in maintenance oral corticosteroid dose, if required. {"}Clinical remission{"} was defined by cessation of exacerbations and maintenance OCS, as well as a normalization of lung function (FEV1%>80%) and an Asthma Control Questionnaire-6 score ≤1.50 after 12 months of treatment.RESULTS: After 12 months of treatment of 501 biologically na{\"i}ve patients, there were 104 (21%) patients with no response to treatment, whereas 397 (79%) had a clinical response. Among the latter, 97 (24%) fulfilled our criteria of clinical remission, corresponding to 19% in the entire population. Remission was predicted by shorter duration of disease and lower BMI in our entire population of all patients treated with biologic therapy.INTERPRETATION: Clinical response was achieved in most adult patients initiating biologic therapy and clinical remission was observed in 19% of the patients after 12 months of treatment. Further studies are required to assess the long-term outcome of achieving clinical remission on biologic therapy.",

author = "Susanne Hansen and Marianne S{\o}ndergaard and {von B{\"u}low}, Anna and Anne-Sofie Bjerrum and Johannes Schmid and Rasmussen, {Linda M} and Johnsen, {Claus R} and Truls Ingebrigtsen and {Julius H{\aa}kansson}, {Kjell Erik} and Johansson, {Sofie Lock} and Maria Bisgaard and Assing, {Karin Dahl} and Ole Hilberg and Charlotte Ulrik and Celeste Porsbjerg",

note = "Copyright {\textcopyright} 2023. Published by Elsevier Inc.",

year = "2023",

month = nov,

day = "2",

doi = "10.1016/j.chest.2023.10.046",

language = "English",

journal = "Chest",

issn = "0012-3692",

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TY - JOUR

T1 - Clinical response and remission in severe asthma patients treated with biologic therapies

AU - Hansen, Susanne

AU - Søndergaard, Marianne

AU - von Bülow, Anna

AU - Bjerrum, Anne-Sofie

AU - Schmid, Johannes

AU - Rasmussen, Linda M

AU - Johnsen, Claus R

AU - Ingebrigtsen, Truls

AU - Julius Håkansson, Kjell Erik

AU - Johansson, Sofie Lock

AU - Bisgaard, Maria

AU - Assing, Karin Dahl

AU - Hilberg, Ole

AU - Ulrik, Charlotte

AU - Porsbjerg, Celeste

PY - 2023/11/2

Y1 - 2023/11/2

N2 - BACKGROUND: The development of novel targeted biologic therapies for severe asthma has provided an opportunity to consider remission as a new treatment goal.RESEARCH QUESTION: How many severe asthma patients treated with biologic therapy achieve clinical remission, and what predicts response to treatment?STUDY DESIGN AND METHODS: The Danish Severe Asthma Registry is a nationwide register including all adult patients receiving biologic therapy for severe asthma in Denmark. We conducted an observational cohort study and defined "clinical response" to treatment after 12 months as ≥50% reduction in exacerbations, and/or a ≥50% reduction in maintenance oral corticosteroid dose, if required. "Clinical remission" was defined by cessation of exacerbations and maintenance OCS, as well as a normalization of lung function (FEV1%>80%) and an Asthma Control Questionnaire-6 score ≤1.50 after 12 months of treatment.RESULTS: After 12 months of treatment of 501 biologically naïve patients, there were 104 (21%) patients with no response to treatment, whereas 397 (79%) had a clinical response. Among the latter, 97 (24%) fulfilled our criteria of clinical remission, corresponding to 19% in the entire population. Remission was predicted by shorter duration of disease and lower BMI in our entire population of all patients treated with biologic therapy.INTERPRETATION: Clinical response was achieved in most adult patients initiating biologic therapy and clinical remission was observed in 19% of the patients after 12 months of treatment. Further studies are required to assess the long-term outcome of achieving clinical remission on biologic therapy.

AB - BACKGROUND: The development of novel targeted biologic therapies for severe asthma has provided an opportunity to consider remission as a new treatment goal.RESEARCH QUESTION: How many severe asthma patients treated with biologic therapy achieve clinical remission, and what predicts response to treatment?STUDY DESIGN AND METHODS: The Danish Severe Asthma Registry is a nationwide register including all adult patients receiving biologic therapy for severe asthma in Denmark. We conducted an observational cohort study and defined "clinical response" to treatment after 12 months as ≥50% reduction in exacerbations, and/or a ≥50% reduction in maintenance oral corticosteroid dose, if required. "Clinical remission" was defined by cessation of exacerbations and maintenance OCS, as well as a normalization of lung function (FEV1%>80%) and an Asthma Control Questionnaire-6 score ≤1.50 after 12 months of treatment.RESULTS: After 12 months of treatment of 501 biologically naïve patients, there were 104 (21%) patients with no response to treatment, whereas 397 (79%) had a clinical response. Among the latter, 97 (24%) fulfilled our criteria of clinical remission, corresponding to 19% in the entire population. Remission was predicted by shorter duration of disease and lower BMI in our entire population of all patients treated with biologic therapy.INTERPRETATION: Clinical response was achieved in most adult patients initiating biologic therapy and clinical remission was observed in 19% of the patients after 12 months of treatment. Further studies are required to assess the long-term outcome of achieving clinical remission on biologic therapy.

U2 - 10.1016/j.chest.2023.10.046

DO - 10.1016/j.chest.2023.10.046

M3 - Journal article

C2 - 37925144

JO - Chest

JF - Chest

SN - 0012-3692

ER -

Clinical response and remission in severe asthma patients treated with biologic therapies

Abstract

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