Hazal Kayikci, Ebru Damadoglu, Melek Cihanbeylerden, Cise Tuccar, Gul Karakaya, Ali Fuat Kalyoncu
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Changes in Asthma Control Questionnaire (ACQ-6) scores, forced expiratory volume in one second (FEV1) percentages, and blood eosinophil counts were assessed at baseline and 6 months. The percentage change in FEV1 (liters) at 6 months relative to baseline was measured. Clinical remission rates were evaluated in those completing one year of treatment. <b>Results:</b> Among 87 patients, 38 (43.7%) had LOA and 49 (56.3%) had EOA. Of these, 22 (25.3%) received omalizumab and 65 (74.7%) received mepolizumab, with a mean treatment duration of 24.7 (±19.7) months. LOA patients had higher obesity rates and tobacco consumption compared to EOA patients (p = 0.041 and p = 0.024, respectively). There were no significant differences between LOA and EOA groups in ACQ scores, FEV1 percentage, the percentage change in FEV1 in liters and eosinophil counts (p = 0.531, p = 0.219, p = 0.632, p = 0.700, respectively). Within LOA patients, ACQ scores did not significantly differ between those treated with omalizumab and mepolizumab (p = 0.801). At 6 months, eosinophil counts significantly decreased with mepolizumab but not with omalizumab (p = 0.002). <b>Conclusion:</b> Biological treatment responses were similar between LOA and EOA groups. 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引用次数: 0
摘要
背景:迟发性哮喘(LOA)的亚表型和对生物制剂的治疗反应的数据有限。本研究将重症哮喘患者分为早发性哮喘(EOA)和早发性哮喘(LOA)两组,比较两组患者接受生物治疗的临床特点和治疗反应。方法:纳入2015年12月至2023年12月在三级保健成人过敏诊所接受omalizumab或mepolizumab治疗至少6个月的患者。结果:87例患者中,38例(43.7%)为LOA, 49例(56.3%)为EOA。其中,22例(25.3%)接受了omalizumab治疗,65例(74.7%)接受了mepolizumab治疗,平均治疗时间为24.7(±19.7)个月。LOA患者肥胖率和烟草消费均高于EOA患者(p = 0.041和p = 0.024)。LOA组与EOA组ACQ评分、FEV1百分比、升FEV1变化百分比和嗜酸性粒细胞计数差异均无统计学意义(p = 0.531, p = 0.219, p = 0.632, p = 0.700)。在LOA患者中,使用omalizumab和mepolizumab治疗的患者ACQ评分无显著差异(p = 0.801)。6个月时,mepolizumab组嗜酸性粒细胞计数显著下降,而omalizumab组则没有(p = 0.002)。结论:LOA组与EOA组生物治疗效果相近。除了LOA患者嗜酸性粒细胞计数变化外,Omalizumab和mepolizumab的疗效相当。
Clinical characteristics and biological treatment responses of patients with late-onset asthma phenotype.
Background: The data on subphenotypes and treatment responses to biologicals in late-onset asthma (LOA) is limited. This study aims to compare the clinical characteristics and treatment responses in severe asthma patients receiving biological treatments, categorized into early-onset asthma (EOA) and LOA groups. Methods: Patients treated with omalizumab or mepolizumab for at least six months at a tertiary care adult allergy clinic between December 2015 and December 2023 were included. Patients with persistent respiratory symptoms starting at age ≥40 years were categorized as LOA, while those with onset <40 years were categorized as EOA. Changes in Asthma Control Questionnaire (ACQ-6) scores, forced expiratory volume in one second (FEV1) percentages, and blood eosinophil counts were assessed at baseline and 6 months. The percentage change in FEV1 (liters) at 6 months relative to baseline was measured. Clinical remission rates were evaluated in those completing one year of treatment. Results: Among 87 patients, 38 (43.7%) had LOA and 49 (56.3%) had EOA. Of these, 22 (25.3%) received omalizumab and 65 (74.7%) received mepolizumab, with a mean treatment duration of 24.7 (±19.7) months. LOA patients had higher obesity rates and tobacco consumption compared to EOA patients (p = 0.041 and p = 0.024, respectively). There were no significant differences between LOA and EOA groups in ACQ scores, FEV1 percentage, the percentage change in FEV1 in liters and eosinophil counts (p = 0.531, p = 0.219, p = 0.632, p = 0.700, respectively). Within LOA patients, ACQ scores did not significantly differ between those treated with omalizumab and mepolizumab (p = 0.801). At 6 months, eosinophil counts significantly decreased with mepolizumab but not with omalizumab (p = 0.002). Conclusion: Biological treatment responses were similar between LOA and EOA groups. Omalizumab and mepolizumab showed comparable efficacy, with the exception of eosinophil count changes in LOA patients.
期刊介绍:
Allergy & Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists. The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma. Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.