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Title: Comparative effectiveness of anti-IL5 and anti-IgE biologic classes in patients with severe asthma eligible for both
Authors: Pfeffer, Paul E.
Ali, Nasloon
Murray, Ruth
Ulrik, Charlotte
Tran, Trung N.
Maspero, Jorge
Peters, Matthew
Christoff, George C.
Sadatsafavi, Mohsen
Torres-Duque, Carlos A.
Altraja, Alan
Lehtimäki, Lauri
Papadopoulos, Nikolaos G.
Salvi, Sundeep
Costello, Richard W.
Cushen, Breda
Heffler, Enrico
Iwanaga, Takashi
Al-Ahmad, Mona
Larenas-Linnemann, Désirée
Kuna, Piotr
Fonseca, João A.
Al-Lehebi, Riyad
Rhee, Chin Kook
Perez-de-Llano, Luis
Perng Steve, Diahn-Warng
Mahboub, Bassam
Wang, Eileen
Goh, Celine
Lyu, Juntao
Newell, Anthony
Alacqua, Marianna
Belevskiy, Andrey S
Bhutani, Mohit
Bjermer, Leif
Bjornsdottir, Unnur
Bourdin, Arnaud
Bulow, Anna von
Busby, John
Canonica, Giorgio Walter
Cosio, Borja G.
Dorscheid, Delbert R.
Muñoz-Esquerre, Mariana
FitzGerald, J. Mark
Gil, Esther Garcia
Gibson, Peter G.
Heaney, Liam G..
Hew, Mark
Hilberg, Ole
Hoyte, Flavia
Jackson, David J.
Koh, Mariko Siyue
Ko, Hsin-Kuo Bruce
Lee, Jae Ha
Lehmann, Sverre
Chaves Loureiro, Cláudia 
Lúðvíksdóttir, Dóra
Menzies-Gow, Andrew N.
Mitchell, Patrick
Papaioannou, Andriana I.
Popov, Todor A.
Porsbjerg, Celeste M.
Salameh, Laila
Sirena, Concetta
Taillé, Camille
Taube, Christian
Tohda, Yuji
Wechsler, Michael E.
Price, David B.
Keywords: biologics; exacerbation; ISAR; oral corticosteroids; real life
Issue Date: Jul-2023
Project: Optimum Patient Care Global 
AstraZeneca Ltd. 
Volume: 78
Issue: 7
Abstract: Background: Patients with severe asthma may present with characteristics representing overlapping phenotypes, making them eligible for more than one class of biologic. Our aim was to describe the profile of adult patients with severe asthma eligible for both anti-IgE and anti-IL5/ 5R and to compare the effectiveness of both classes of treatment in real life. Methods: This was a prospective cohort study that included adult patients with severe asthma from 22 countries enrolled into the International Severe Asthma registry (ISAR) who were eligible for both anti-IgE and anti-IL5/ 5R. The effectiveness of anti-IgE and anti-IL5/ 5R was compared in a 1:1 matched cohort. Exacerbation rate was the primary effectiveness endpoint. Secondary endpoints included long-term- oral corticosteroid (LTOCS) use, asthma-related emergency room (ER) attendance, and hospital admissions. Results: In the matched analysis (n = 350/group), the mean annualized exacerbation rate decreased by 47.1% in the anti-IL5/ 5R group and 38.7% in the anti-IgE group. Patients treated with anti-IL5/ 5R were less likely to experience a future exacerbation (adjusted IRR 0.76; 95% CI 0.64, 0.89; p < 0.001) and experienced a greater reduction in mean LTOCS dose than those treated with anti-IgE (37.44% vs. 20.55% reduction; p = 0.023). There was some evidence to suggest that patients treated with anti-IL5/ 5R experienced fewer asthma-related hospitalizations (IRR 0.64; 95% CI 0.38, 1.08), but not ER visits (IRR 0.94, 95% CI 0.61, 1.43). Conclusions: In real life, both anti-IgE and anti-IL5/ 5R improve asthma outcomes in patients eligible for both biologic classes; however, anti-IL5/ 5R was superior in terms of reducing asthma exacerbations and LTOCS use.
ISSN: 0105-4538
DOI: 10.1111/all.15711
Rights: openAccess
Appears in Collections:FMUC Medicina - Artigos em Revistas Internacionais

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