Marianne Baastrup Soendergaard, Kjell Erik Julius Håkansson, Susanne Hansen, Anne-Sofie Bjerrum, Johannes Martin Schmid, Sofie Lock Johansson, Linda Makowska Rasmussen, Barbara Bonnesen, Roxana Vijdea, Anna von Bülow, Niels Steen Krogh, Ole Hilberg, Simon Francis Thomsen, Charlotte Suppli Ulrik, Celeste Porsbjerg
{"title":"丹麦成人严重哮喘和共病特应性皮炎患者一线Dupilumab的生物处方模式和生物标志物决定因素","authors":"Marianne Baastrup Soendergaard, Kjell Erik Julius Håkansson, Susanne Hansen, Anne-Sofie Bjerrum, Johannes Martin Schmid, Sofie Lock Johansson, Linda Makowska Rasmussen, Barbara Bonnesen, Roxana Vijdea, Anna von Bülow, Niels Steen Krogh, Ole Hilberg, Simon Francis Thomsen, Charlotte Suppli Ulrik, Celeste Porsbjerg","doi":"10.1111/cea.70117","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Asthma and atopic dermatitis are common type-2 (T2)-driven diseases that often coexist, although different T2 biomarkers indicate disease severity in each condition. Multiple biologics target T2 inflammation, but only dupilumab has been approved for both diseases. Little is known about patients with severe asthma and comorbid atopic dermatitis, particularly regarding how this comorbidity influences the choice of biologic for severe asthma.</p><p><strong>Methods: </strong>We utilised the nationwide Danish Severe Asthma Register to characterise patients with severe asthma and comorbid atopic dermatitis, and describe prescription patterns of biologics in patients with and without comorbid atopic dermatitis. We compared biomarker determinants of first-line dupilumab prescription between the two groups using a multivariate logistic regression model adjusting for age and sex.</p><p><strong>Results: </strong>We identified 1137 patients initiating a biologic for severe asthma, of whom 192 (17%) had comorbid atopic dermatitis. Patients with comorbid atopic dermatitis more often had childhood-onset asthma with an allergic phenotype. The prescription patterns of biologics differed according to comorbid atopic dermatitis status, and patients with comorbid atopic dermatitis were more likely to switch (OR 3.02, p < 0.001). In patients with comorbid atopic dermatitis, elevated IgE was the strongest biomarker determinant of first-line dupilumab prescription (OR 8.77, p < 0.001), whereas in patients without, it was elevated FeNO (OR 1.76, p = 0.03).</p><p><strong>Conclusion: </strong>Biologic prescription patterns in severe asthma vary according to comorbid atopic dermatitis status. In patients with comorbid atopic dermatitis, elevated IgE predicts first-line dupilumab prescription, indicating that the severity of atopic dermatitis influences treatment decisions. Additional research is needed to explore the management of coexisting T2 diseases with biological therapies.</p>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":5.2000,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Biologic Prescription Patterns and Biomarker Determinants of First-Line Dupilumab in Danish Adult Patients With Severe Asthma and Comorbid Atopic Dermatitis.\",\"authors\":\"Marianne Baastrup Soendergaard, Kjell Erik Julius Håkansson, Susanne Hansen, Anne-Sofie Bjerrum, Johannes Martin Schmid, Sofie Lock Johansson, Linda Makowska Rasmussen, Barbara Bonnesen, Roxana Vijdea, Anna von Bülow, Niels Steen Krogh, Ole Hilberg, Simon Francis Thomsen, Charlotte Suppli Ulrik, Celeste Porsbjerg\",\"doi\":\"10.1111/cea.70117\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Asthma and atopic dermatitis are common type-2 (T2)-driven diseases that often coexist, although different T2 biomarkers indicate disease severity in each condition. Multiple biologics target T2 inflammation, but only dupilumab has been approved for both diseases. Little is known about patients with severe asthma and comorbid atopic dermatitis, particularly regarding how this comorbidity influences the choice of biologic for severe asthma.</p><p><strong>Methods: </strong>We utilised the nationwide Danish Severe Asthma Register to characterise patients with severe asthma and comorbid atopic dermatitis, and describe prescription patterns of biologics in patients with and without comorbid atopic dermatitis. We compared biomarker determinants of first-line dupilumab prescription between the two groups using a multivariate logistic regression model adjusting for age and sex.</p><p><strong>Results: </strong>We identified 1137 patients initiating a biologic for severe asthma, of whom 192 (17%) had comorbid atopic dermatitis. Patients with comorbid atopic dermatitis more often had childhood-onset asthma with an allergic phenotype. The prescription patterns of biologics differed according to comorbid atopic dermatitis status, and patients with comorbid atopic dermatitis were more likely to switch (OR 3.02, p < 0.001). In patients with comorbid atopic dermatitis, elevated IgE was the strongest biomarker determinant of first-line dupilumab prescription (OR 8.77, p < 0.001), whereas in patients without, it was elevated FeNO (OR 1.76, p = 0.03).</p><p><strong>Conclusion: </strong>Biologic prescription patterns in severe asthma vary according to comorbid atopic dermatitis status. In patients with comorbid atopic dermatitis, elevated IgE predicts first-line dupilumab prescription, indicating that the severity of atopic dermatitis influences treatment decisions. Additional research is needed to explore the management of coexisting T2 diseases with biological therapies.</p>\",\"PeriodicalId\":10207,\"journal\":{\"name\":\"Clinical and Experimental Allergy\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.2000,\"publicationDate\":\"2025-07-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical and Experimental Allergy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/cea.70117\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ALLERGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Experimental Allergy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/cea.70117","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ALLERGY","Score":null,"Total":0}
Biologic Prescription Patterns and Biomarker Determinants of First-Line Dupilumab in Danish Adult Patients With Severe Asthma and Comorbid Atopic Dermatitis.
Background: Asthma and atopic dermatitis are common type-2 (T2)-driven diseases that often coexist, although different T2 biomarkers indicate disease severity in each condition. Multiple biologics target T2 inflammation, but only dupilumab has been approved for both diseases. Little is known about patients with severe asthma and comorbid atopic dermatitis, particularly regarding how this comorbidity influences the choice of biologic for severe asthma.
Methods: We utilised the nationwide Danish Severe Asthma Register to characterise patients with severe asthma and comorbid atopic dermatitis, and describe prescription patterns of biologics in patients with and without comorbid atopic dermatitis. We compared biomarker determinants of first-line dupilumab prescription between the two groups using a multivariate logistic regression model adjusting for age and sex.
Results: We identified 1137 patients initiating a biologic for severe asthma, of whom 192 (17%) had comorbid atopic dermatitis. Patients with comorbid atopic dermatitis more often had childhood-onset asthma with an allergic phenotype. The prescription patterns of biologics differed according to comorbid atopic dermatitis status, and patients with comorbid atopic dermatitis were more likely to switch (OR 3.02, p < 0.001). In patients with comorbid atopic dermatitis, elevated IgE was the strongest biomarker determinant of first-line dupilumab prescription (OR 8.77, p < 0.001), whereas in patients without, it was elevated FeNO (OR 1.76, p = 0.03).
Conclusion: Biologic prescription patterns in severe asthma vary according to comorbid atopic dermatitis status. In patients with comorbid atopic dermatitis, elevated IgE predicts first-line dupilumab prescription, indicating that the severity of atopic dermatitis influences treatment decisions. Additional research is needed to explore the management of coexisting T2 diseases with biological therapies.
期刊介绍：
Clinical & Experimental Allergy strikes an excellent balance between clinical and scientific articles and carries regular reviews and editorials written by leading authorities in their field.
In response to the increasing number of quality submissions, since 1996 the journals size has increased by over 30%. Clinical & Experimental Allergy is essential reading for allergy practitioners and research scientists with an interest in allergic diseases and mechanisms. Truly international in appeal, Clinical & Experimental Allergy publishes clinical and experimental observations in disease in all fields of medicine in which allergic hypersensitivity plays a part.
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