A comparison of treatment response to biologics in asthma-COPD overlap and pure asthma: Findings from the PRISM study

Ji-Su Shim, MD, PhD; Hyunkyoung Kim, MS; Jae-Woo Kwon, MD, PhD; So-Young Park, MD, PhD; Sujeong Kim, MD, PhD; Byung-Keun Kim, MD, PhD; Young-Hee Nam, MD, PhD; Min-Suk Yang, MD, PhD; Mi-Yeong Kim, MD, PhD; Sae-Hoon Kim, MD, PhD; Byung-Jae Lee, MD, PhD; Taehoon Lee, MD, PhD; Sang-Ha Kim, MD, PhD; So Young Park, MD, PhD; Young-Joo Cho, MD, PhD; Chan Sun Park, MD, PhD; Jae-Woo Jung, MD, PhD; Han-Ki Park, MD, PhD; Joo-Hee Kim, MD, PhD; Jeong-Hee Choi, MD, PhD; Ji-Yong Moon, MD, PhD; Ian Adcock, MD, PhD; Kian Fan Chung, MD, PhD; Min-Hye Kim, MD, PhD; Tae-Bum Kim, MD, PhD

World Allergy Organization Journal (Dec 2023)

A comparison of treatment response to biologics in asthma-COPD overlap and pure asthma: Findings from the PRISM study

Ji-Su Shim, MD, PhD,
Hyunkyoung Kim, MS,
Jae-Woo Kwon, MD, PhD,
So-Young Park, MD, PhD,
Sujeong Kim, MD, PhD,
Byung-Keun Kim, MD, PhD,
Young-Hee Nam, MD, PhD,
Min-Suk Yang, MD, PhD,
Mi-Yeong Kim, MD, PhD,
Sae-Hoon Kim, MD, PhD,
Byung-Jae Lee, MD, PhD,
Taehoon Lee, MD, PhD,
Sang-Ha Kim, MD, PhD,
So Young Park, MD, PhD,
Young-Joo Cho, MD, PhD,
Chan Sun Park, MD, PhD,
Jae-Woo Jung, MD, PhD,
Han-Ki Park, MD, PhD,
Joo-Hee Kim, MD, PhD,
Jeong-Hee Choi, MD, PhD,
Ji-Yong Moon, MD, PhD,
Ian Adcock, MD, PhD,
Kian Fan Chung, MD, PhD,
Min-Hye Kim, MD, PhD,
Tae-Bum Kim, MD, PhD

Affiliations

Ji-Su Shim, MD, PhD: Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, South Korea
Hyunkyoung Kim, MS: Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Jae-Woo Kwon, MD, PhD: Department of Allergy and Clinical Immunology, Kangwon National University School of Medicine, Chuncheon, South Korea
So-Young Park, MD, PhD: Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
Sujeong Kim, MD, PhD: Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
Byung-Keun Kim, MD, PhD: Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
Young-Hee Nam, MD, PhD: Department of Internal Medicine, Dong-A University College of Medicine, Busan, South Korea
Min-Suk Yang, MD, PhD: Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
Mi-Yeong Kim, MD, PhD: Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
Sae-Hoon Kim, MD, PhD: Department of Internal Medicine, Division of Allergy and Clinical Immunology, Seoul National University Bundang Hospital, Seongnam, South Korea
Byung-Jae Lee, MD, PhD: Departments of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Taehoon Lee, MD, PhD: Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
Sang-Ha Kim, MD, PhD: Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea
So Young Park, MD, PhD: Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, South Korea
Young-Joo Cho, MD, PhD: Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, South Korea
Chan Sun Park, MD, PhD: Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
Jae-Woo Jung, MD, PhD: Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea
Han-Ki Park, MD, PhD: Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea; Division of Allergy and Clinical Immunology, Department of Internal Medicine, Kyungpook National University Chilgok Hospital, Daegu, South Korea
Joo-Hee Kim, MD, PhD: Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
Jeong-Hee Choi, MD, PhD: Department of Pulmonology and Allergy, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, South Korea
Ji-Yong Moon, MD, PhD: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
Ian Adcock, MD, PhD: National Heart and Lung Institute, Imperial College London, United Kingdom
Kian Fan Chung, MD, PhD: National Heart and Lung Institute, Imperial College London, United Kingdom
Min-Hye Kim, MD, PhD: Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, South Korea; Corresponding author. Department of Internal Medicine, Ewha Womans University College of Medicine, 260 Gonghang-daero, Gangseo-gu, Seoul 07804, Republic of Korea.
Tae-Bum Kim, MD, PhD: Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Corresponding author. Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea.

Journal volume & issue: Vol. 16, no. 12
p. 100848

Abstract

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Background: Despite the increasing use of biologics in severe asthma, there is limited research on their use in asthma-chronic obstructive pulmonary disease overlap (ACO). We compared real-world treatment responses to biologics in ACO and asthma. Methods: We conducted a multicenter, retrospective, cohort study using data from the Precision Medicine Intervention in Severe Asthma (PRISM). ACO was defined as post-bronchodilator forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) 10 pack-years. Physicians selected biologics (omalizumab, mepolizumab, reslizumab, benralizumab, and dupilumab) based on each United States Food & Drug Administration (FDA) approval criteria. Results: After six-month treatment with biologics, both patients with ACO (N = 13) and asthma (N = 81) showed positive responses in FEV1 (10.69 ± 17.17 vs. 11.25 ± 12.87 %, P = 0.652), Asthma Control Test score (3.33 ± 5.47 vs. 5.39 ± 5.42, P = 0.290), oral corticosteroid use (−117.50 ± 94.38 vs. −115.06 ± 456.85 mg, P = 0.688), fractional exhaled nitric oxide levels (−18.62 ± 24.68 vs. −14.66 ± 45.35 ppb, P = 0.415), sputum eosinophils (−3.40 ± 10.60 vs. −14.48 ± 24.01 %, P = 0.065), blood eosinophils (−36.47 ± 517.02 vs. −363.22 ± 1294.59, P = 0.013), and exacerbation frequency (−3.07 ± 4.42 vs. −3.19 ± 5.11, P = 0.943). The odds ratio for exacerbation and time-to-first exacerbation showed no significant difference after full adjustments, and subgroup analysis according to biologic type was also showed similar results. Conclusions: Biologics treatment response patterns in patients with ACO and asthma were comparable, suggesting that biologics should be actively considered for ACO patients as well.

Published in World Allergy Organization Journal

ISSN: 1939-4551 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Immunologic diseases. Allergy
Website: https://www.sciencedirect.com/journal/world-allergy-organization-journal

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