Journal of Asthma and Allergy (Mar 2022)

The Response to Biologics is Better in Patients with Severe Asthma Than in Patients with Asthma–COPD Overlap Syndrome

  • Pérez de Llano L,
  • Dacal Rivas D,
  • Marina Malanda N,
  • Plaza Moral V,
  • Gullón Blanco JA,
  • Muñoz-Esquerre M,
  • García-Moguel I,
  • Díaz Campos R,
  • Martínez-Moragón E,
  • Harbenau Mena A,
  • Cosío BG,
  • Padilla Galo A,
  • Cisneros Serrano C

Journal volume & issue
Vol. Volume 15
pp. 363 – 369

Abstract

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Luis Pérez de Llano,1 David Dacal Rivas,1 Nuria Marina Malanda,2 Vicente Plaza Moral,3 José Antonio Gullón Blanco,4 Mariana Muñoz-Esquerre,5 Ismael García-Moguel,6 Rocío M Díaz Campos,7 Eva Martínez-Moragón,8 Alicia Harbenau Mena,9 Borja G Cosío,10 Alicia Padilla Galo,11 Carolina Cisneros Serrano12 1Pneumology Service, Hospital Lucus Augusti, EOXI Lugo, Cervo e Monforte, Lugo, Spain; 2Pneumology Service, Hospital Universitario de Cruces, Barakaldo, Bizkaia, Spain; 3Pneumology Service, Hospital Sta Creu i Sant Pau, Barcelona, Spain; 4Pneumology Service, University Hospital San Agustín, Avilés, Spain; 5Pneumology Service, Hospital Bellvitge-IDIBELL, Barcelona, Spain; 6Allergy Service, Hospital 12 de Octubre, Madrid, Spain; 7Pneumology Service, Institute for Health Research (i+12), Hospital Universitario 12 de Octubre, Madrid, Spain; 8Pneumology Service, Hospital Doctor Peset, Valencia, Spain; 9Allergy Service, Hospital de Mérida, Badajoz, Spain; 10Pneumology Service, Hospital Universitario Son Espases-IdISBa-CIBERES, Palma de Mallorca, Spain; 11Pneumology Service, Hospital Costa del Sol, Marbella, Málaga, Spain; 12Pneumology Service, Hospital Universitario de La Princesa, Madrid, SpainCorrespondence: David Dacal Rivas, Pneumology Service, University Hospital Lucus Augusti, Lugo, Spain, Tel +34982296000, Email [email protected]: Although biologics have demonstrated to be effective in T2-high asthma patients, there is little experience with these drugs in asthma–COPD overlap (ACO). The aim of this study was to compare the effectiveness of biologics in these two conditions. We included 318 patients (24 ACO and 297 asthma) treated with monoclonal antibodies and followed for at least 12 months. Omalizumab was the most frequently employed biologic agent both in patients with ACO and asthma. Asthma control test (ACT) scores after at least 12 months of biologic therapy were not significantly different between groups. The percentage of patients with ≥ 1 exacerbation and ≥ 1 corticosteroid burst was significantly higher in ACO patients (70.8 vs 27.3 and 83.3% vs 37.5%, respectively), whereas the percentage of “controlled” patients (with no exacerbations, no need for corticosteroids and ACT ≥ 20) was significantly lower (16.7% vs 39.7%). In conclusion, this report suggests that patients with ACO treated with biologics reach worse outcomes than asthma patients.Keywords: asthma, asthma–COPD overlap, COPD

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