Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep;11(9):2724-2731.e2.
doi: 10.1016/j.jaip.2023.05.041. Epub 2023 Jun 7.

Real-World Effectiveness of IL-5/5Ra Targeted Biologics in Severe Eosinophilic Asthma With Comorbid Bronchiectasis

Sarah A Bendien  1 , Johannes A Kroes  2 , Lotte H G van Hal  2 , Gert-Jan Braunstahl  3 , Marielle E A C Broeders  4 , Karen T M Oud  5 , Kornelis Wiebe Patberg  6 , Frank W J M Smeenk  7 , Ilonka H P A A van Veen  8 , Els J M Weersink  9 , Karin B Fieten  10 , Simone Hashimoto  9 , Anneke van Veen  11 , Jaap K Sont  12 , Astrid van Huisstede  13 , Marjo J T van de Ven  14 , Bas Langeveld  15 , Anke-Hilse Maitland-van der Zee  9 , Anneke Ten Brinke  16 ; Registry of Adult Patients With Severe Asthma for Optimal Disease Management Team
Affiliations

Real-World Effectiveness of IL-5/5Ra Targeted Biologics in Severe Eosinophilic Asthma With Comorbid Bronchiectasis

Sarah A Bendien et al. J Allergy Clin Immunol Pract. 2023 Sep.

Abstract

Background: Bronchiectasis is a common comorbidity in patients with asthma and is associated with increased disease severity. In patients with severe eosinophilic asthma, biologics targeting IL-5/5Ra have beneficial effects on oral corticosteroid (OCS) use and exacerbation frequency. However, how coexisting bronchiectasis affects the response to such treatments is unknown.

Objective: To evaluate the real-world effectiveness of anti-IL-5/5Ra therapy in patients with severe eosinophilic asthma and comorbid bronchiectasis on exacerbation frequency and daily maintenance and cumulative OCS dose.

Methods: This real-world study evaluated data from 97 adults with severe eosinophilic asthma and computed tomography-confirmed bronchiectasis from the Dutch Severe Asthma Registry, who initiated anti-IL5/5Ra biologics (mepolizumab, reslizumab, and benralizumab) and had follow-up data for 12 months or greater. The analysis was performed for the total population and subgroups with or without maintenance OCS use.

Results: Anti-IL-5/5Ra therapy significantly reduced exacerbation frequency in patients with maintenance OCS use as well as in those without it. In the year before biologic initiation, 74.5% of all patients had two or more exacerbations, which decreased to 22.1% in the follow-up year (P < .001). The proportion of patients on maintenance OCS decreased from 47% to 30% (P < .001), and in the OCS-dependent patients (n = 45) maintenance OCS dose decreased from median (interquartile range) of 10.0 mg/d (5-15 mg/d) to 2.5 mg/d (0-5 mg/d) after 1 year (P < .001).

Conclusions: This real-world study shows that anti-IL-5/5Ra therapy reduces exacerbation frequency and daily maintenance as well as the cumulative OCS dose in patients with severe eosinophilic asthma and comorbid bronchiectasis. Although it is an exclusion criterion in phase 3 trials, comorbid bronchiectasis should not preclude anti-IL-5/5Ra therapy in patients with severe eosinophilic asthma.

Keywords: Biologic therapy; Bronchiectasis; Oral corticosteroids; Severe asthma.

PubMed Disclaimer

Publication types