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Observational Study
. 2024 Feb;79(2):384-392.
doi: 10.1111/all.15867. Epub 2023 Aug 25.

Biologics (mepolizumab and omalizumab) induced remission in severe asthma patients

Affiliations
Observational Study

Biologics (mepolizumab and omalizumab) induced remission in severe asthma patients

Dennis Thomas et al. Allergy. 2024 Feb.

Abstract

Background: Asthma remission has emerged as a potential treatment goal. This study evaluated the effectiveness of two biologics (mepolizumab/omalizumab) in achieving asthma remission.

Methods: This observational study included 453 severe asthma patients (41% male; mean age ± SD 55.7 ± 14.7 years) from two real-world drug registries: the Australian Mepolizumab Registry and the Australian Xolair Registry. The composite outcome clinical remission was defined as zero exacerbations and zero oral corticosteroids during the previous 6 months assessed at 12 months and 5-item Asthma Control Questionnaire (ACQ-5) ≤1 at 12 months. We also assessed clinical remission plus optimization (post-bronchodilator FEV1 ≥80%) or stabilization (post-bronchodilator FEV1 not greater than 5% decline from baseline) of lung function at 12 months. Sensitivity analyses explored various cut-offs of ACQ-5/FEV1 scores. The predictors of clinical remission were identified.

Results: 29.3% (73/249) of AMR and 22.8% (37/162) of AXR cohort met the criteria for clinical remission. When lung function criteria were added, the remission rates were reduced to 25.2% and 19.1%, respectively. Sensitivity analyses identified that the remission rate ranged between 18.1% and 34.9% in the AMR cohort and 10.6% and 27.2% in the AXR cohort. Better lung function, lower body mass index, mild disease and absence of comorbidities such as obesity, depression and osteoporosis predicted the odds of achieving clinical remission.

Conclusion: Biologic treatment with mepolizumab or omalizumab for severe asthma-induced asthma remission in a subgroup of patients. Remission on treatment may be an achievable treatment target and future studies should consider remission as an outcome measure.

Keywords: asthma; mepolizumab; omalizumab; remission.

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References

REFERENCES

    1. The Global Asthma Report 2018. Global Asthma Network; 2018.
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    1. Thomas D, McDonald VM, Pavord ID, Gibson PG. Asthma remission-what is it and how can it be achieved? Eur Respir J. 2022;60(5):2102583.
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    1. Menzies-Gow A, Szefler SJ, Busse WW. The relationship of asthma biologics to remission for asthma. J Allergy Clin Immunol Pract. 2021;9(3):1090-1098.

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