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Comparative effectiveness of Anti-IL5 and Anti-IgE biologic classes in severe asthma patients eligible for both
  • +65
  • David Price,
  • paul pfeffer,
  • Nasloon Ali,
  • Ruth Murray,
  • Charlotte Ulrik,
  • Trung Tran,
  • Jorge Maspero,
  • Matthew Peters,
  • George Christoff,
  • Mohsen Sadatsafavi,
  • Carlos A. Torres-Duque,
  • Alan Altraja,
  • Lauri Lehtimäki,
  • Nikolaos Papadopoulos,
  • Sundeep Salvi,
  • Richard W. Costello,
  • Breda Cushen,
  • Enrico Heffler,
  • Takashi Iwanaga,
  • Mona Al-Ahmad ,
  • Désirée Larenas-Linnemann,
  • Piotr Kuna,
  • João Fonseca,
  • Riyad Al-Lehebi,
  • Chin Kook Rhee,
  • Luis Perez de Llano,
  • Diahn-Wang Perng,
  • Bassam Mahboub,
  • Eileen Wang,
  • Yun Yi Celine Goh,
  • Juntao Lyu,
  • Anthony Newell,
  • Marianna Alacqua,
  • Mohit Bhutani,
  • Leif Bjermer,
  • Unnur Steina Björnsdóttir,
  • Arnaud Bourdin,
  • Anna Von Bülow,
  • John Busby,
  • Walter Canonica,
  • Borja G Cosio,
  • Delbert Dorscheid,
  • Mariana Muñoz Esquerre,
  • Mark FitzGerald,
  • Esther Garcia Gil,
  • Peter Gerard Gibson,
  • Liam Heaney,
  • Mark Hew,
  • Ole Hilberg,
  • Flavia Hoyte,
  • David Jackson,
  • Mariko Koh,
  • Hsin-Kuo Ko,
  • Jae Ha Lee,
  • Sverre Lehmann,
  • Claudia Chaves Loureiro,
  • Dora Ludviksdottir,
  • Andrew Menzies-Gow,
  • Patrick Mitchell,
  • Andriana Papaioannou,
  • Todor Popov,
  • Celeste Porsbjerg,
  • Laila Salameh,
  • Concetta Sirena,
  • Camille Taillé,
  • Christian Taube,
  • Yuji Tohda,
  • M. E. Wechsler
David Price
Observational and Pragmatic Research Institute Singapore Singapore

Corresponding Author:[email protected]

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paul pfeffer
Barts Health NHS Trust
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Nasloon Ali
Observational and Pragmatic Research Institute Singapore Singapore
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Ruth Murray
Optimum Patient Care Global Cambridge UK
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Charlotte Ulrik
Department of Respiratory Medicine Copenhagen University Hospital - Hvidovre
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Trung Tran
AstraZeneca R&D Gaithersburg
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Jorge Maspero
Clinical Research for Allergy and Respiratory Medicine CIDEA Foundation Buenos Aires Argentina
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Matthew Peters
Department of Thoracic Medicine Concord Hospital Sydney Australia
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George Christoff
Medicinski universitet-Sofia
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Mohsen Sadatsafavi
Respiratory Evaluation Sciences Program Faculty of Pharmaceutical Sciences The University of British Columbia
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Carlos A. Torres-Duque
CINEUMO Respiratory Research Center Fundación Neumológica Colombiana Bogotá Colombia
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Alan Altraja
Department of Pulmonology University of Tartu and Lung Clinic Tartu University Hospital Tartu Estonia
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Lauri Lehtimäki
Allergy Centre Tampere University Hospital Faculty of Medicine and Health Technology Tampere University Tampere Finland
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Nikolaos Papadopoulos
Division of Infection Immunity & Respiratory Medicine University of Manchester Manchester UK
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Sundeep Salvi
Pulmocare Research and Education Foundation Pune India
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Richard W. Costello
Clinical Research Centre Smurfit Building Beaumont Hospital Department of Respiratory Medicine RCSI Dublin Ireland
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Breda Cushen
Department of Respiratory Medicine Beaumont Hospital Dublin Ireland
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Enrico Heffler
Humanitas University
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Takashi Iwanaga
Kindai University Hospital Osakasayama Japan
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Mona Al-Ahmad
Microbiology Department College of Medicine Kuwait University Kuwait Al-Rashed Allergy Center Ministry of Health Kuwait
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Désirée Larenas-Linnemann
Centro de Excelencia en Asma y Alergia Hospital Médica Sur Ciudad de México Mexico
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Piotr Kuna
Division of Internal Medicine Asthma and Allergy Medical University of Lodz Poland
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João Fonseca
CINTESIS @ RISE Porto University Medical School Porto Portugal
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Riyad Al-Lehebi
King Fahad Medical City
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Chin Kook Rhee
Division 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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Luis Perez de Llano
Pneumology Service Lucus Augusti University Hospital EOXI Lugo Monforte Cervo
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Diahn-Wang Perng
National Yang Ming Chiao Tung University Library
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Bassam Mahboub
Dubai Health Authority
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Eileen Wang
National Jewish Health and University of Colorado School of Medicine
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Yun Yi Celine Goh
Observational and Pragmatic Research Institute Singapore Singapore
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Juntao Lyu
Observational and Pragmatic Research Institute Singapore Singapore
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Anthony Newell
Observational and Pragmatic Research Institute Singapore Singapore
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Marianna Alacqua
CSL Behring SpA Milan Italy
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Mohit Bhutani
Division of Pulmonary Medicine Department of Medicine University of Alberta Alberta Canada
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Leif Bjermer
Respiratory Medicine and Allergology Department of Clinical Sciences Skåne University Hospital Lund University Lund Sweden
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Unnur Steina Björnsdóttir
Department of Allergy and Respiratory Medicine University Hospital Reykjavik Iceland
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Arnaud Bourdin
PhyMedExp Univ Montpellier CNRS INSERM CHU Montpellier Montpellier France
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Anna Von Bülow
Respiratory Research Unit Bispebjerg University Hospital Copenhagen Denmark
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John Busby
Queen's University Belfast School of Medicine Dentistry and Biomedical Sciences
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Walter Canonica
Personalized Medicine Asthma and Allergy Humanitas Clinical and Research Center IRCCS Rozzano Milan Italy
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Borja G Cosio
Son Espases University Hospital-IdISBa-Ciberes Mallorca Spain
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Delbert Dorscheid
The University of British Columbia
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Mariana Muñoz Esquerre
Department of Respiratory Medicine Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL)
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Mark FitzGerald
Department of Medicine The University of British Columbia Vancouver Canada
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Esther Garcia Gil
AstraZeneca Barcelona Spain
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Peter Gerard Gibson
Australian Severe Asthma Network Priority Research Centre for Healthy Lungs University of Newcastle Newcastle Australia
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Liam Heaney
Queen's University Belfast Wellcome-Wolfson Institute for Experimental Medicine
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Mark Hew
Allergy Asthma & Clinical Immunology Service Alfred Health Melbourne Australia
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Ole Hilberg
Medical department Vejle University Hospital Denmark
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Flavia Hoyte
National Jewish Health Division of Allergy & Clinical Immunology
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David Jackson
Guy's Hospital
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Mariko Koh
Singapore General Hospital
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Hsin-Kuo Ko
Taipei Veterans General Hospital Hsinchu Branch
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Jae Ha Lee
Inje University - Busan Campus
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Sverre Lehmann
Section of Thoracic Medicine Department of Clinical Science University of Bergen Bergen Norway
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Claudia Chaves Loureiro
Pneumology Unit Hospitais da Universidade de Coimbra Centro Hospitalar e Universitário de Coimbra Coimbra Portugal
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Dora Ludviksdottir
Department of Respiratory Medicine Landspitali University Hospital Reykjavik Iceland University of Iceland
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Andrew Menzies-Gow
Royal Brompton Hospital
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Patrick Mitchell
School of Medicine Trinity College Dublin Ireland
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Andriana Papaioannou
2nd Respiratory Medicine Department National and Kapodistrian University of Athens Medical School Attikon University Hospital Athens Greece
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Todor Popov
University Hospital "Sv Ivan Rilski" Sofia Bulgaria
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Celeste Porsbjerg
Bispebjerg Hospital
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Laila Salameh
Dubai Health Authority
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Concetta Sirena
Severe Asthma Network Italy (SANI) Milano Italy
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Camille Taillé
Department of Respiratory Diseases Bichat Hospital AP-HP Nord-Université de Paris Paris France
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Christian Taube
Department of Pulmonary Medicine University Medical Center Essen-Ruhrlandklinik Germany
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Yuji Tohda
Kindai University Hospital Osakasayama Japan
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M. E. Wechsler
NJH Cohen Family Asthma Institute Department of Medicine National Jewish Health Denver CO USA
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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 severe adult asthma patients 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 severe asthma patients 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.
26 Sep 2022Submitted to Allergy
13 Oct 2022Submission Checks Completed
13 Oct 2022Assigned to Editor
13 Oct 2022Review(s) Completed, Editorial Evaluation Pending
16 Oct 2022Reviewer(s) Assigned
15 Nov 2022Editorial Decision: Revise Minor
14 Dec 20221st Revision Received
14 Dec 2022Assigned to Editor
14 Dec 2022Submission Checks Completed
14 Dec 2022Review(s) Completed, Editorial Evaluation Pending
18 Dec 2022Reviewer(s) Assigned
23 Dec 2022Editorial Decision: Accept