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Busse W, Castro M. Asthma Updates: Theories Translated to Targeted Treatment. The Journal of Allergy and Clinical Immunology: In Practice 2024; 12:908-910. [PMID: 38346473 DOI: 10.1016/j.jaip.2024.01.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 01/31/2024] [Indexed: 02/26/2024]
Affiliation(s)
- William Busse
- Department of Medicine, University of Wisconsin School of Medicine, Madison, Wis.
| | - Mario Castro
- Department of Medicine, University of Kansas School of Medicine, Overland Park, Kan
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2
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Pelaia C, Pelaia G, Busse W. Do Comorbidities Influence the Response to Biologics in Severe Asthma? Am J Respir Crit Care Med 2024; 209:233-235. [PMID: 38064716 PMCID: PMC10840761 DOI: 10.1164/rccm.202311-2103ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Affiliation(s)
- Corrado Pelaia
- Department of Medical and Surgical Sciences University "Magna Graecia" of Catanzaro Catanzaro, Italy
| | - Girolamo Pelaia
- Department of Health Sciences University "Magna Graecia" of Catanzaro Catanzaro, Italy
| | - William Busse
- Allergy, Pulmonary and Critical Care Medicine University of Wisconsin School of Medicine and Public Health Madison, Wisconsin
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3
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Diamant Z, Jesenak M, Hanania NA, Heaney LG, Djukanovic R, Ryan D, Quirce S, Backer V, Gaga M, Pavord I, Antolín-Amérigo D, Assaf S, Bakakos P, Bobcakova A, Busse W, Kappen J, Loukides S, van Maaren M, Panzner P, Pite H, Spanevello A, Stenberg H, Striz I, Thio B, Vasakova MK, Conti D, Fokkens W, Lau S, Scadding GK, Van Staeyen E, Hellings PW, Bjermer L. EUFOREA pocket guide on the diagnosis and management of asthma: An educational and practical tool for general practitioners, non-respiratory physicians, paramedics and patients. Respir Med 2023; 218:107361. [PMID: 37517623 DOI: 10.1016/j.rmed.2023.107361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/07/2023] [Accepted: 07/07/2023] [Indexed: 08/01/2023]
Affiliation(s)
- Zuzana Diamant
- Department of Microbiology Immunology & Transplantation, KU Leuven, Catholic University of Leuven, Belgium; Department of Respiratory Medicine & Allergology, Institute for Clinical Science, Skane University Hospital, Lund University, Lund, Sweden; Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic; Department of Clinical Pharmacy & Pharmacology, University in Groningen, University Medical Center Groningen, Groningen, Netherlands.
| | - Milos Jesenak
- Department of Pediatrics, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Teaching Hospital in Martin, Martin, Slovakia; Department of Pulmonology and Phthisiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Teaching Hospital in Martin, Martin, Slovakia; Department of Clinical Immunology and Allergology, University Teaching Hospital in Martin, Martin, Slovakia.
| | - Nicola A Hanania
- Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, TX, USA.
| | - Liam G Heaney
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, UK.
| | - Ratko Djukanovic
- NIHR Southampton Biomedical Centre, Faculty of Medicine, University of Southampton, UK.
| | - Dermot Ryan
- AUKCAR, Usher Institute, University of Edinburgh, Edinburgh, UK.
| | - Santiago Quirce
- Department of Allergy, La Paz University Hospital, IdiPAZ; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain.
| | - Vibeke Backer
- Otorhinolaryngology Head & Neck Surgery and Audiology, Rigshospitalet, Copenhagen, University Hospital, Copenhagen, Denmark.
| | - Mina Gaga
- Athens Chest Hospital, Athens, Greece.
| | - Ian Pavord
- Respiratory Medicine Unit and Oxford Respiratory NIHR BRC, Nuffield Department of Medicine, Unversity of Oxford, UK.
| | - Darío Antolín-Amérigo
- Servicio de Alergia, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS) Madrid, Spain.
| | - Sara Assaf
- Assistant Professor of Pulmonary Critical Care and Sleep Medicine at the University of New Mexico, Albuquerque, NM, USA.
| | - Petros Bakakos
- 1th University Department of Respiratory Medicine, National and Kapodistrian University of Athens, Greece.
| | - Anna Bobcakova
- Department of Pulmonology and Phthisiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Teaching Hospital in Martin, Martin, Slovakia.
| | - William Busse
- University of Wisconsin School of Medicine and Public Health, Division of Allergy, Pulmonary and Critical Care Medicine, Madison, WI, USA.
| | - Jasper Kappen
- Department of Pulmonology, STZ Centre of Excellence for Asthma, COPD and Respiratory Allergy, Franciscus Gasthuis and Vlietland, Rotterdam, the Netherlands; Department of National Heart and Lung Institute, Immunomodulation and Tolerance Group, Allergy and Clinical Immunology, Imperial College London, London, UK.
| | - Stelios Loukides
- National and Kapodistrian University of Athens Medical School Attiko University Hospital,2nd Respiratory Medicine Dept, Athens, Greece.
| | - Maurits van Maaren
- Department of Internal Medicine, Allergy and Clinical Immunology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
| | - Petr Panzner
- Department of Immunology and Allergology, Faculty of Medicine and Faculty Hospital, Charles University Prague, Pilsen, Czech Republic.
| | - Helena Pite
- Immunoallergy Department, CUF Tejo Hospital & Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal; iNOVA4Health, NOVA Medical School, Universidade NOVA de Lisboa, Portugal.
| | - Antonio Spanevello
- University of Insubria, Varese, Italy; ICS Maugeri, IRCCS, Tradate, Italy.
| | - Henning Stenberg
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Sweden.
| | - Ilja Striz
- Department of Clinical and Transplant Immunology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; Institute of Immunology and Microbiology, First Faculty of Medicine, Charles University, Prague, Czech Republic; Subdivision of Allergology and Clinical Immunology, Institute for Postgraduate Education in Medicine, Prague, Czech Republic.
| | - Boony Thio
- Department of Pediatrics, Medisch Spectrum Twente, Enschede, the Netherlands.
| | - Martina Koziar Vasakova
- Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic.
| | - Diego Conti
- The European Forum for Research and Education in Allergy and Airway Diseases Scientific Expert Team Members, Brussels, Belgium.
| | - Wytske Fokkens
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, Amsterdam, the Netherlands.
| | - Susanne Lau
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Germany.
| | - Glenis K Scadding
- Royal National ENT Hospital, London and Division of Immunity and Infection, University College, London, UK.
| | - Elizabeth Van Staeyen
- The European Forum for Research and Education in Allergy and Airway Diseases Scientific Expert Team Members, Brussels, Belgium.
| | - Peter W Hellings
- Department of Otorhinolaryngology, And Laboratory of Allergy and Clinical Immunology, University of Leuven, Belgium; Upper Airways Disease Laboratory, University of Ghent, Belgium.
| | - Leif Bjermer
- Department of Respiratory Medicine & Allergology, Institute for Clinical Science, Skane University Hospital, Lund University, Lund, Sweden.
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De Prado Gomez L, Pavord I, Busse W, Brightling CE, Wechsler ME, Rabe KF, Zhang M, Xing J, Jacob-Nara JA, Rowe PJ. Long-term effect of dupilumab on prevention of lung function decline in patients with uncontrolled moderate-to-severe asthma: ATLAS trial design. ERJ Open Res 2023; 9:00417-2022. [PMID: 36891077 PMCID: PMC9986762 DOI: 10.1183/23120541.00417-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/20/2022] [Indexed: 11/18/2022] Open
Abstract
Background Many patients with asthma experience loss of lung function over time, and in certain patients this can lead to progressive obstructive patterns similar to COPD. Patients with severe asthma may experience accelerated lung function decline (LFD). However, characteristics and risk factors for LFD in asthma have not been well described. Dupilumab may prevent or slow the rate of LFD in patients with uncontrolled, moderate-to-severe asthma. ATLAS trial is designed to evaluate the role of dupilumab in preventing/slowing LFD over a period of 3 years versus standard-of-care therapy. Methods ATLAS (clinicaltrials.gov identifier NCT05097287) is a randomised, double-blind, placebo-controlled, multicentre study that will include adult patients with uncontrolled moderate-to-severe asthma. ∼1828 patients will be randomised (2:1) to dupilumab 300 mg or placebo in combination with maintenance therapy every 2 weeks for 3 years. The primary objective is to assess the effect of dupilumab on preventing or slowing LFD by year 1 in the exhaled nitric oxide fraction (F eNO) population (patients with F eNO ≥35 ppb). The effect of dupilumab in slowing the rate of LFD by year 2 and year 3 in both F eNO and total populations, exacerbations, asthma control, quality of life, biomarker changes and utility of F eNO as a biomarker of LFD will also be evaluated. Discussion ATLAS is the first trial assessing the effect of a biologic on LFD, designed to establish the role of dupilumab in prevention of long-term loss of lung function and its potential effect on disease modification, which may provide unique insights into asthma pathophysiology, including predictive and prognostic factors of LFD.
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Affiliation(s)
| | - Ian Pavord
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - William Busse
- UW Allergy, Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Christopher E Brightling
- Institute for Lung Health, NIHR Leicester Biomedical Research Center, Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | | | - Klaus F Rabe
- LungenClinic Grosshansdorf (member of the German Center for Lung Research (DZL)), Airway Research Center North (ARCN), Grosshansdorf, Germany.,Christian-Albrechts University (member of the DZL), ARCN, Kiel, Germany
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Patel S, Altman M, Cox M, Bacharier L, Calatroni A, Gill M, Stokes J, Liu A, Cohen R, Makhija M, Hershey GK, O’Connor G, Zoratti E, Teach S, Kattan M, Becker P, Togias A, Busse W, Jackson D. Epithelial-Associated Inflammatory Pathways Underlie Residual Asthma Exacerbations in Urban Children Treated with Mepolizumab Therapy. J Allergy Clin Immunol 2023. [DOI: 10.1016/j.jaci.2022.12.692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Papi A, Castro M, Busse W, Korn S, Xia C, Soler X, Pandit-Abid N, Radwan A, Jacob-Nara J, Rowe P, Deniz Y. Dupilumab Reduces Exacerbations And Improves Lung Function Regardless Of Prior Asthma Exacerbation Status: LIBERTY ASTHMA TRAVERSE Open-Label Extension Study. J Allergy Clin Immunol 2023. [DOI: 10.1016/j.jaci.2022.12.605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Zoratti E, Wood R, O G, Pongracic J, Makhija M, Hershey GK, Sherenian M, Gill M, Gruchalla R, Chambliss J, Liu A, Kattan M, Busse P, Bacharier L, Rivera-Spoljaric K, Sheehan W, Jackson D, Gergen P, Togias A, Calatroni A, Visness C, Cho K, Sette A, Altman M, Busse W. The Effect of Subcutaneous German Cockroach Immunotherapy (SCIT) on Nasal Allergen Challenge (NAC) and Cockroach-specific Antibody Responses Among Urban Children and Adolescents. J Allergy Clin Immunol 2023. [DOI: 10.1016/j.jaci.2022.12.737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Gaberino C, Segnitz RM, Cox M, Bacharier L, Calatroni A, Gill M, Stokes J, Liu A, Cohen R, Makhija M, Hershey GK, O'Connor G, Zoratti E, Teach S, Kattan M, Becker P, Togias A, Busse W, Jackson D, Altman M. Mepolizumab Alters Regulation of Airway Type-2 Inflammation in Urban Children with Asthma by Disrupting Eosinophil Gene Expression but Enhancing Mast Cell and Epithelial Pathways. J Allergy Clin Immunol 2023. [DOI: 10.1016/j.jaci.2022.12.396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Busse W, Bartels C, Rosenkranz M. Brain-Airway Interactions in Asthma. Adv Exp Med Biol 2023; 1426:185-214. [PMID: 37464122 DOI: 10.1007/978-3-031-32259-4_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Asthma and brain interactions have long been appreciated and initially centered on increased anxiety and depression. Epidemiology studies have shown that early life stressors and situational disadvantages are risk factors for asthma. Conversely, the presence of asthma is a risk for mood and anxiety disorders, thus indicating a bidirectional effect between asthma and brain-related health. To substantiate asthma-brain interactions, validated instruments indicate and elucidate that communication likely exists between asthma and the brain. For example, provocation of an asthmatic response with an allergen challenge modulates how the brain responds to emotion-laden information. As detected by imaging studies, emotion-related brain activation is associated with generating airway inflammation. However, the specific mediators and processes mediating airway communication with the brain have yet to be established.Systemic inflammation is also associated with asthma and can affect other organ systems such as the cardiovascular system and the brain. Epidemiology studies have shown that asthma is a risk factor for dementia and Alzheimer's disease. In support of the importance of asthma as a risk factor for impaired cognitive function, imaging studies have shown changes to the white matter of the brain in asthma patients that resemble neuroinflammation changes seen in Alzheimer's disease and other neurodegenerative diseases. Therefore, bidirectional links between asthma and the brain exist with an important next research step to define asthma-brain interactions linked to neurodegeneration and dementia and explore whether treatments directed toward asthma-related inflammation can prevent the deleterious effects of asthma on brain health.
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Affiliation(s)
- William Busse
- Department of Medicine, Division of Allergy Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
| | - Christie Bartels
- Department of Medicine, Division of Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Melissa Rosenkranz
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Murphy TR, Busse W, Holweg CTJ, Rajput Y, Raimundo K, Meyer CS, Seetasith A, Gupta S, Iqbal A, Kaner RJ. Patients with allergic asthma have lower risk of severe COVID-19 outcomes than patients with nonallergic asthma. BMC Pulm Med 2022; 22:418. [PMCID: PMC9660106 DOI: 10.1186/s12890-022-02230-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
Background Although asthma does not appear to be a risk factor for severe coronavirus disease 2019 (COVID-19), outcomes could vary for patients with different asthma subtypes. The objective of this analysis was to compare COVID-19 outcomes in real-world cohorts in the United States among patients with asthma, with or without evidence of allergy. Methods In a retrospective analysis of the COVID-19 Optum electronic health record dataset (February 20, 2020–January 28, 2021), patients diagnosed with COVID-19 with a history of moderate-to-severe asthma were divided into 2 cohorts: those with evidence of allergic asthma and those without (nonallergic asthma). After 1:1 propensity score matching, in which covariates were balanced and potential bias was removed, COVID-19 outcomes were compared between cohorts. Results From a COVID-19 population of 591,198 patients, 1595 patients with allergic asthma and 8204 patients with nonallergic asthma were identified. After propensity score matching (n = 1578 per cohort), risk of death from any cause after COVID-19 diagnosis was significantly lower for patients with allergic vs nonallergic asthma (hazard ratio, 0.48; 95% CI 0.28–0.83; P = 0.0087), and a smaller proportion of patients with allergic vs nonallergic asthma was hospitalized within − 7 to + 30 days of COVID-19 diagnosis (13.8% [n = 217] vs 18.3% [n = 289]; P = 0.0005). Among hospitalized patients, there were no significant differences between patients with allergic or nonallergic asthma in need for intensive care unit admission, respiratory support, or COVID-19 treatment. Conclusions Asthma subtype may influence outcomes after COVID-19; patients with allergic asthma are at lower risk for hospitalization/death than those with nonallergic asthma.
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Affiliation(s)
- Thomas R. Murphy
- grid.478146.8ENT and Allergy Partners of Charleston, Charleston, SC USA
| | - William Busse
- grid.14003.360000 0001 2167 3675University of Wisconsin School of Medicine and Public Health, Madison, WI USA
| | - Cecile T. J. Holweg
- grid.418158.10000 0004 0534 4718Genentech, Inc., South San Francisco, CA USA
| | - Yamina Rajput
- grid.418158.10000 0004 0534 4718Genentech, Inc., South San Francisco, CA USA
| | - Karina Raimundo
- grid.418158.10000 0004 0534 4718Genentech, Inc., South San Francisco, CA USA
| | - Craig S. Meyer
- grid.418158.10000 0004 0534 4718Genentech, Inc., South San Francisco, CA USA
| | - Arpamas Seetasith
- grid.418158.10000 0004 0534 4718Genentech, Inc., South San Francisco, CA USA
| | - Sachin Gupta
- grid.418158.10000 0004 0534 4718Genentech, Inc., South San Francisco, CA USA
| | - Ahmar Iqbal
- grid.418158.10000 0004 0534 4718Genentech, Inc., South San Francisco, CA USA
| | - Robert J. Kaner
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
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Washington C, Dapas M, Biddanda A, Magnaye KM, Aneas I, Helling BA, Szczesny B, Boorgula MP, Taub MA, Kenny E, Mathias RA, Barnes KC, Khurana Hershey GK, Kercsmar CM, Gereige JD, Makhija M, Gruchalla RS, Gill MA, Liu AH, Rastogi D, Busse W, Gergen PJ, Visness CM, Gold DR, Hartert T, Johnson CC, Lemanske RF, Martinez FD, Miller RL, Ownby D, Seroogy CM, Wright AL, Zoratti EM, Bacharier LB, Kattan M, O'Connor GT, Wood RA, Nobrega MA, Altman MC, Jackson DJ, Gern JE, McKennan CG, Ober C. African-specific alleles modify risk for asthma at the 17q12-q21 locus in African Americans. Genome Med 2022; 14:112. [PMID: 36175932 PMCID: PMC9520885 DOI: 10.1186/s13073-022-01114-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 09/15/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Asthma is the most common chronic disease in children, occurring at higher frequencies and with more severe disease in children with African ancestry. METHODS We tested for association with haplotypes at the most replicated and significant childhood-onset asthma locus at 17q12-q21 and asthma in European American and African American children. Following this, we used whole-genome sequencing data from 1060 African American and 100 European American individuals to identify novel variants on a high-risk African American-specific haplotype. We characterized these variants in silico using gene expression and ATAC-seq data from airway epithelial cells, functional annotations from ENCODE, and promoter capture (pc)Hi-C maps in airway epithelial cells. Candidate causal variants were then assessed for correlation with asthma-associated phenotypes in African American children and adults. RESULTS Our studies revealed nine novel African-specific common variants, enriched on a high-risk asthma haplotype, which regulated the expression of GSDMA in airway epithelial cells and were associated with features of severe asthma. Using ENCODE annotations, ATAC-seq, and pcHi-C, we narrowed the associations to two candidate causal variants that are associated with features of T2 low severe asthma. CONCLUSIONS Previously unknown genetic variation at the 17q12-21 childhood-onset asthma locus contributes to asthma severity in individuals with African ancestries. We suggest that many other population-specific variants that have not been discovered in GWAS contribute to the genetic risk for asthma and other common diseases.
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Affiliation(s)
- Charles Washington
- Department of Human Genetics, The University of Chicago, 928 E. 58th St. CLSC 507C, Chicago, IL, 60637, USA
| | - Matthew Dapas
- Department of Human Genetics, The University of Chicago, 928 E. 58th St. CLSC 507C, Chicago, IL, 60637, USA
| | - Arjun Biddanda
- Department of Human Genetics, The University of Chicago, 928 E. 58th St. CLSC 507C, Chicago, IL, 60637, USA
| | - Kevin M Magnaye
- Department of Human Genetics, The University of Chicago, 928 E. 58th St. CLSC 507C, Chicago, IL, 60637, USA
| | - Ivy Aneas
- Department of Human Genetics, The University of Chicago, 928 E. 58th St. CLSC 507C, Chicago, IL, 60637, USA
| | - Britney A Helling
- Department of Human Genetics, The University of Chicago, 928 E. 58th St. CLSC 507C, Chicago, IL, 60637, USA
| | - Brooke Szczesny
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | | | - Margaret A Taub
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Eimear Kenny
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rasika A Mathias
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Kathleen C Barnes
- Department of Medicine, University of Colorado Denver, Aurora, CO, USA
| | | | - Carolyn M Kercsmar
- Division of Asthma Research, Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - Jessica D Gereige
- Department of Medicine, Division of Pulmonary, Allergy, Sleep, and Critical Care Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Melanie Makhija
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | | | - Michelle A Gill
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Andrew H Liu
- Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, CO, USA
| | - Deepa Rastogi
- Children's National Hospital and George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - William Busse
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | | | - Diane R Gold
- The Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Tina Hartert
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Christine C Johnson
- Department of Public Health Sciences, Henry Ford Health Systems, Detroit, MI, USA
| | - Robert F Lemanske
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Fernando D Martinez
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA
| | - Rachel L Miller
- Department of Medicine, Division of Clinical Immunology Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dennis Ownby
- Department of Public Health Sciences, Henry Ford Health Systems, Detroit, MI, USA
| | - Christine M Seroogy
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Anne L Wright
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA
| | - Edward M Zoratti
- Department of Medicine, Henry Ford Health Systems, Detroit, MI, USA
| | - Leonard B Bacharier
- Department of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt University Medical Center, Nashville, TN, USA
| | - Meyer Kattan
- Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
| | - George T O'Connor
- Pulmonary Center, Boston University School of Medicine, Boston, MA, USA
| | - Robert A Wood
- Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA
| | - Marcelo A Nobrega
- Department of Human Genetics, The University of Chicago, 928 E. 58th St. CLSC 507C, Chicago, IL, 60637, USA
| | - Matthew C Altman
- Immunology Division, Benaroya Research Institute Systems, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Daniel J Jackson
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - James E Gern
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | - Carole Ober
- Department of Human Genetics, The University of Chicago, 928 E. 58th St. CLSC 507C, Chicago, IL, 60637, USA.
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Busse W, Stempel D, Aggarwal B, Boucot I, Forth R, Raphiou I, Rabe KF, Reddel HK. Insights from the AUSTRI study on reliever use before and after asthma exacerbations. J Allergy Clin Immunol Pract 2022; 10:1916-1918.e2. [PMID: 35413473 DOI: 10.1016/j.jaip.2022.03.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 03/15/2022] [Accepted: 03/31/2022] [Indexed: 06/14/2023]
Affiliation(s)
- William Busse
- University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | | | | | | | | | | | - Klaus F Rabe
- Lungen Clinic Grosshansdorf, Grosshansdorf, Germany; Department of Medicine, University of Kiel, German Center of Lung Research (DZL), Kiel, Germany
| | - Helen K Reddel
- The Woolcock Institute of Medical Research and The University of Sydney, Sydney, Australia
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13
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Higgins E, Davidson R, Busse W, Rosenkranz M. Brain functional changes associated with mindfulness training-related improvement in asthma control. J Allergy Clin Immunol 2022. [DOI: 10.1016/j.jaci.2021.12.504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Jackson D, Bacharier L, Gergen P, Gagalis L, Villarreal M, Gill M, Liu A, Gruchalla R, Cohen R, Makhija M, Hershey GK, Sherenian M, Rivera-Spoljaric K, Stokes J, Zoratti E, Teach S, Kattan M, Visness C, Becker P, Gern J, Sorkness C, Busse W, Altman M. Phenotype-directed Therapy with Mepolizumab for Urban Children with Exacerbation-Prone Asthma. J Allergy Clin Immunol 2022. [DOI: 10.1016/j.jaci.2021.12.492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Prussin C, Bozik M, Mather J, Archibald D, Dworetzky S, Killingsworth R, Ochkur S, Jacobsen E, Siddiqui S, Busse W. The Oral Eosinophil-lowering Drug Dexpramipexole Improves FEV1 Largely Thorough its Effect on FVC. J Allergy Clin Immunol 2022. [DOI: 10.1016/j.jaci.2021.12.097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Corren J, Jackson D, Casale T, Borish L, Rabe K, Busse W, Maspero J, Jackson D, Daizadeh N, Ortiz B, Jacob-Nara J, Khodzhayev A, Rowe P, Djandji M, Deniz Y. Dupilumab Efficacy in LIBERTY ASTHMA QUEST Patients With Uncontrolled, Moderate-to-Severe Asthma By Allergen Sensitization Status. J Allergy Clin Immunol 2022. [DOI: 10.1016/j.jaci.2021.12.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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17
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Busse W, Wellman A, Bachert C, Siddiqui S, Zhang H, Khan A, Jacob-Nara J, Rowe P, Deniz Y. P184 IMPACT OF DUPILUMAB ON SLEEP/FUNCTION SCORES IN PATIENTS WITH CHRONIC RHINOSINUSITIS WITH NASAL POLYPS. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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18
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Zein JG, McManus JM, Sharifi N, Erzurum SC, Marozkina N, Lahm T, Giddings O, Davis MD, DeBoer MD, Comhair SA, Bazeley P, Kim HJ, Busse W, Calhoun W, Castro M, Chung KF, Fahy JV, Israel E, Jarjour NN, Levy BD, Mauger DT, Moore WC, Ortega VE, Peters M, Bleecker ER, Meyers DA, Zhao Y, Wenzel SE, Gaston B. Benefits of Airway Androgen Receptor Expression in Human Asthma. Am J Respir Crit Care Med 2021; 204:285-293. [PMID: 33779531 DOI: 10.1164/rccm.202009-3720oc] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rationale: Androgens are potentially beneficial in asthma, but AR (androgen receptor) has not been studied in human airways.Objectives: To measure whether AR and its ligands are associated with human asthma outcomes.Methods: We compared the effects of AR expression on lung function, symptom scores, and fractional exhaled nitric oxide (FeNO) in adults enrolled in SARP (Severe Asthma Research Program). The impact of sex and of androgens on asthma outcomes was also evaluated in the SARP with validation studies in the Cleveland Clinic Health System and the NHANES (U.S. National Health and Nutrition Examination Survey).Measurements and Main Results: In SARP (n = 128), AR gene expression from bronchoscopic epithelial brushings was positively associated with both FEV1/FVC ratio (R2 = 0.135, P = 0.0002) and the total Asthma Quality of Life Questionnaire score (R2 = 0.056, P = 0.016) and was negatively associated with FeNO (R2 = 0.178, P = 9.8 × 10-6) and NOS2 (nitric oxide synthase gene) expression (R2 = 0.281, P = 1.2 × 10-10). In SARP (n = 1,659), the Cleveland Clinic Health System (n = 32,527), and the NHANES (n = 2,629), women had more asthma exacerbations and emergency department visits than men. The levels of the AR ligand precursor dehydroepiandrosterone sulfate correlated positively with the FEV1 in both women and men.Conclusions: Higher bronchial AR expression and higher androgen levels are associated with better lung function, fewer symptoms, and a lower FeNO in human asthma. The role of androgens should be considered in asthma management.
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Affiliation(s)
- Joe G Zein
- Lerner Research Institute and.,Respiratory Institute, Cleveland Clinic, Cleveland, Ohio
| | | | | | - Serpil C Erzurum
- Lerner Research Institute and.,Respiratory Institute, Cleveland Clinic, Cleveland, Ohio
| | | | | | | | | | - Mark D DeBoer
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia
| | - Suzy A Comhair
- Lerner Research Institute and.,Respiratory Institute, Cleveland Clinic, Cleveland, Ohio
| | - Peter Bazeley
- Lerner Research Institute and.,Respiratory Institute, Cleveland Clinic, Cleveland, Ohio
| | - Hyun Jo Kim
- Department of Systems Biology and Bioinformatics, Case Western Reserve University, Cleveland, Ohio
| | - William Busse
- Department of Medicine, School of Medicine, University of Wisconsin, Madison, Wisconsin
| | - William Calhoun
- Department of Medicine, University of Texas Medical Branch, University of Texas, Galveston, Texas
| | - Mario Castro
- Division of Pulmonary, Critical Care, and Sleep Medicine, School of Medicine, University of Kansas, Kansas City, Kansas
| | - Kian Fan Chung
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - John V Fahy
- Division of Pulmonary, Critical Care, and Sleep Medicine, School of Medicine, University of Kansas, Kansas City, Kansas.,Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California at San Francisco, San Francisco, California
| | - Elliot Israel
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital and Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Nizar N Jarjour
- Department of Medicine, School of Medicine, University of Wisconsin, Madison, Wisconsin
| | - Bruce D Levy
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital and Harvard Medical School, Harvard University, Boston, Massachusetts
| | - David T Mauger
- Center for Biostatistics and Epidemiology, School of Medicine, Pennsylvania State University, Hershey, Pennsylvania
| | - Wendy C Moore
- Section on Pulmonary, Critical Care, Allergic, and Immunologic Disease, Department of Internal Medicine, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Victor E Ortega
- Section on Pulmonary, Critical Care, Allergic, and Immunologic Disease, Department of Internal Medicine, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Michael Peters
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California at San Francisco, San Francisco, California
| | - Eugene R Bleecker
- Division of Genetics, Genomics, and Precision Medicine, Department of Medicine, University of Arizona, Tucson, Arizona; and
| | - Deborah A Meyers
- Division of Genetics, Genomics, and Precision Medicine, Department of Medicine, University of Arizona, Tucson, Arizona; and
| | - Yi Zhao
- Department of Biostatistics and Health Science Data, School of Medicine, Indiana University, Indianapolis, Indiana
| | - Sally E Wenzel
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, Pennsylvania
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Choi T, Devries M, Bacharier LB, Busse W, Camargo CA, Cohen R, Demuri GP, Evans MD, Fitzpatrick AM, Gergen PJ, Grindle K, Gruchalla R, Hartert T, Hasegawa K, Khurana Hershey GK, Holt P, Homil K, Jartti T, Kattan M, Kercsmar C, Kim H, Laing IA, LeBeau P, Lee KE, Le Souëf PN, Liu A, Mauger DT, Ober C, Pappas T, Patel SJ, Phipatanakul W, Pongracic J, Seroogy C, Sly PD, Tisler C, Wald ER, Wood R, Gangnon R, Jackson DJ, Lemanske RF, Gern JE, Bochkov YA. Enhanced Neutralizing Antibody Responses to Rhinovirus C and Age-Dependent Patterns of Infection. Am J Respir Crit Care Med 2021; 203:822-830. [PMID: 33357024 PMCID: PMC8017585 DOI: 10.1164/rccm.202010-3753oc] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 12/23/2020] [Indexed: 01/10/2023] Open
Abstract
Rationale: Rhinovirus (RV) C can cause asymptomatic infection and respiratory illnesses ranging from the common cold to severe wheezing.Objectives: To identify how age and other individual-level factors are associated with susceptibility to RV-C illnesses.Methods: Longitudinal data from the COAST (Childhood Origins of Asthma) birth cohort study were analyzed to determine relationships between age and RV-C infections. Neutralizing antibodies specific for RV-A and RV-C (three types each) were determined using a novel PCR-based assay. Data were pooled from 14 study cohorts in the United States, Finland, and Australia, and mixed-effects logistic regression was used to identify factors related to the proportion of RV-C versus RV-A detection.Measurements and Main Results: In COAST, RV-A and RV-C infections were similarly common in infancy, whereas RV-C was detected much less often than RV-A during both respiratory illnesses and scheduled surveillance visits (P < 0.001, χ2) in older children. The prevalence of neutralizing antibodies to RV-A or RV-C types was low (5-27%) at the age of 2 years, but by the age of 16 years, RV-C seropositivity was more prevalent (78% vs. 18% for RV-A; P < 0.0001). In the pooled analysis, the RV-C to RV-A detection ratio during illnesses was significantly related to age (P < 0.0001), CDHR3 genotype (P < 0.05), and wheezing illnesses (P < 0.05). Furthermore, certain RV types (e.g., C2, C11, A78, and A12) were consistently more virulent and prevalent over time.Conclusions: Knowledge of prevalent RV types, antibody responses, and populations at risk based on age and genetics may guide the development of vaccines or other novel therapies against this important respiratory pathogen.
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Affiliation(s)
- Timothy Choi
- University of Wisconsin-Madison, Madison, Wisconsin
| | - Mark Devries
- University of Wisconsin-Madison, Madison, Wisconsin
| | | | | | | | | | | | | | - Anne M Fitzpatrick
- Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Peter J Gergen
- National Institute of Allergy and Infectious Disease, National Institutes of Health, Rockville, Maryland
| | | | | | | | | | | | - Patrick Holt
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | | | - Tuomas Jartti
- University of Turku, Turku, Finland
- Universities of Oulu, Oulu, Finland
| | | | | | - Haejin Kim
- Henry Ford Health Systems, Detroit, Michigan
| | - Ingrid A Laing
- University of Western Australia, Perth, Western Australia, Australia
| | | | | | - Peter N Le Souëf
- University of Western Australia, Perth, Western Australia, Australia
| | - Andrew Liu
- University of Colorado, Denver, Colorado
| | | | | | | | | | | | | | | | - Peter D Sly
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia; and
| | | | - Ellen R Wald
- University of Wisconsin-Madison, Madison, Wisconsin
| | - Robert Wood
- Johns Hopkins University, Baltimore, Maryland
| | | | | | | | - James E Gern
- University of Wisconsin-Madison, Madison, Wisconsin
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20
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Rabe K, FitzGerald JM, Castro M, Pavord I, Maspero J, Busse W, Daizadeh N, Ortiz B, Pandit-Abid N, Rowe P, Nikhil A, Deniz Y. Dupilumab Efficacy in GINA-Defined Difficult-to-Treat Type 2 Asthma Patients in the LIBERTY ASTHMA QUEST Study. J Allergy Clin Immunol 2021. [DOI: 10.1016/j.jaci.2020.12.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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21
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Pavord I, Busse W, Israel E, Szefler S, Chen Z, Daizadeh N, Lederer D, Mannent L, Amin N, Laws E, Ruddy M, Rowe P, Deniz Y, Khan A, Zhang Y. Dupilumab Treatment Leads to Clinical Asthma Remission in Patients With Uncontrolled Moderate-to-Severe Asthma With Type 2 Inflammation. J Allergy Clin Immunol 2021. [DOI: 10.1016/j.jaci.2020.12.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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22
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Tabberer M, Trigg A, Busse W, Lund V, Lee J, Bachert C, Senior B, Buchheit K, Diamant Z, Sousa A, Smith S, Mayer B, Yancey S, Chan R. Mepolizumab reduces disease symptoms for Patients with Chronic Rhinosinusitis with Nasal Polyps: Data from the SYNAPSE study. J Allergy Clin Immunol 2021. [DOI: 10.1016/j.jaci.2020.12.462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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23
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Oppenheimer J, Brusselle G, Busse W, Fowler A, Jain N, Mannino D, Pavord I, Win P, Zarankaite A, Kerwin E. P202 CAPTAIN STUDY: TREATMENT OUTCOMES FROM FLUTICASONE FUROATE/UMECLIDINIUM/VILANTEROL ACCORDING TO HISTORY OF SEVERE ASTHMA EXACERBATIONS. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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24
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Holguin F, Camargo C, Busse W, Hanania N, Pennington E, Chiddarwar H, Nelson G, Ortega H. IMPACT OF CHANGES IN THE 2019 GINA TREATMENT CLASSIFICATION: ASSESSMENT IN A REAL-WORLD SETTING. Chest 2020. [DOI: 10.1016/j.chest.2020.08.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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25
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Akdis CA, Arkwright PD, Brüggen MC, Busse W, Gadina M, Guttman‐Yassky E, Kabashima K, Mitamura Y, Vian L, Wu J, Palomares O. Type 2 immunity in the skin and lungs. Allergy 2020; 75:1582-1605. [PMID: 32319104 DOI: 10.1111/all.14318] [Citation(s) in RCA: 258] [Impact Index Per Article: 64.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 04/06/2020] [Indexed: 12/12/2022]
Abstract
There has been extensive progress in understanding the cellular and molecular mechanisms of inflammation and immune regulation in allergic diseases of the skin and lungs during the last few years. Asthma and atopic dermatitis (AD) are typical diseases of type 2 immune responses. interleukin (IL)-25, IL-33, and thymic stromal lymphopoietin are essential cytokines of epithelial cells that are activated by allergens, pollutants, viruses, bacteria, and toxins that derive type 2 responses. Th2 cells and innate lymphoid cells (ILC) produce and secrete type 2 cytokines such as IL-4, IL-5, IL-9, and IL-13. IL-4 and IL-13 activate B cells to class-switch to IgE and also play a role in T-cell and eosinophil migration to allergic inflammatory tissues. IL-13 contributes to maturation, activation, nitric oxide production and differentiation of epithelia, production of mucus as well as smooth muscle contraction, and extracellular matrix generation. IL-4 and IL-13 open tight junction barrier and cause barrier leakiness in the skin and lungs. IL-5 acts on activation, recruitment, and survival of eosinophils. IL-9 contributes to general allergic phenotype by enhancing all of the aspects, such as IgE and eosinophilia. Type 2 ILC contribute to inflammation in AD and asthma by enhancing the activity of Th2 cells, eosinophils, and their cytokines. Currently, five biologics are licensed to suppress type 2 inflammation via IgE, IL-5 and its receptor, and IL-4 receptor alpha. Some patients with severe atopic disease have little evidence of type 2 hyperactivity and do not respond to biologics which target this pathway. Studies in responder and nonresponder patients demonstrate the complexity of these diseases. In addition, primary immune deficiency diseases related to T-cell maturation, regulatory T-cell development, and T-cell signaling, such as Omenn syndrome, severe combined immune deficiencies, immunodysregulation, polyendocrinopathy, enteropathy, X-linked syndrome, and DOCK8, STAT3, and CARD11 deficiencies, help in our understanding of the importance and redundancy of various type 2 immune components. The present review aims to highlight recent advances in type 2 immunity and discuss the cellular sources, targets, and roles of type 2 mechanisms in asthma and AD.
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Affiliation(s)
- Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
| | - Peter D. Arkwright
- Lydia Becker Institute of Immunology and Inflammation University of Manchester Manchester UK
| | - Marie-Charlotte Brüggen
- Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
- Department of Dermatology University Hospital Zurich Zurich Switzerland
- Faculty of Medicine University Zurich Zurich Switzerland
| | - William Busse
- Department of Medicine School of Medicine and Public Health University of Wisconsin Madison WI USA
| | - Massimo Gadina
- Translational Immunology Section Office of Science and Technology National Institute of Arthritis Musculoskeletal and Skin Disease NIH Bethesda MD USA
| | - Emma Guttman‐Yassky
- Department of Dermatology, and Laboratory of Inflammatory Skin Diseases Icahn School of Medicine at Mount Sinai New York NY USA
- Laboratory for Investigative Dermatology The Rockefeller University New York NY USA
| | - Kenji Kabashima
- Department of Dermatology Kyoto University Graduate School of Medicine Kyoto Japan
- Agency for Science, Technology and Research (A*STAR) Singapore Immunology Network (SIgN) and Skin Research Institute of Singapore (SRIS) Singapore Singapore
| | - Yasutaka Mitamura
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Laura Vian
- Translational Immunology Section Office of Science and Technology National Institute of Arthritis Musculoskeletal and Skin Disease NIH Bethesda MD USA
| | - Jianni Wu
- Department of Dermatology, and Laboratory of Inflammatory Skin Diseases Icahn School of Medicine at Mount Sinai New York NY USA
- Laboratory for Investigative Dermatology The Rockefeller University New York NY USA
| | - Oscar Palomares
- Department of Biochemistry and Molecular Biology School of Chemistry Complutense University of Madrid Madrid Spain
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Holguin F, Hanania N, Pennington E, Busse W, Tubman R, Zigmont E, Nelson G, Dittrich K, Ortega H, Camargo C. Corticosteroid Use Across Asthma Health-Care Providers: A Real-world Experience. J Allergy Clin Immunol 2020. [DOI: 10.1016/j.jaci.2019.12.563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Rabe K, FitzGerald J, Bateman E, Castro M, Pavord I, Maspero J, Busse W, Rice M, Deniz Y, Rowe P, Patel N, Amin N, Ruddy M, Graham N, Teper A. Dupilumab Efficacy in GINA-Defined Difficult-to-Treat Type 2 Asthma Patients. J Allergy Clin Immunol 2020. [DOI: 10.1016/j.jaci.2019.12.785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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28
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Jackson D, Flynn K, Rosasco M, Gill M, Liu A, Gruchalla R, O G, Pongracic J, Kercsmar C, Hershey GK, Zoratti E, Teach S, Kattan M, Bacharier L, Gergen P, Wheatley L, Presnell S, Togias A, Busse W, Altman M. The Influence of MUC5AC SNPs on expression of MUC5AC and mucus hypersecretion genes during asthma exacerbations. J Allergy Clin Immunol 2020. [DOI: 10.1016/j.jaci.2019.12.371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Busse W, Pavord I, Wenzel S, Bateman E, Casale T, FitzGerald J, Rice M, Deniz Y, Patel N, Harel S, Rowe P, Graham N, O’Riordan T. Baseline FeNO as a Prognostic Biomarker for Subsequent Severe Asthma Exacerbations in Patients With Uncontrolled, Moderate-to-Severe Asthma Receiving Placebo in the LIBERTY ASTHMA QUEST Study. J Allergy Clin Immunol 2020. [DOI: 10.1016/j.jaci.2019.12.792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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30
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Pennington E, Camargo C, Hanania N, Holguin F, Tubman R, Zigmont E, Nelson G, Dittrich K, Ortega H, Busse W. P210 INDICATORS OF ASTHMA EXACERBATION BEFORE INITIATION OF BIOLOGIC THERAPY: A REAL-WORLD EXPERIENCE. Ann Allergy Asthma Immunol 2019. [DOI: 10.1016/j.anai.2019.08.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Bateman ED, Busse W, Pedersen SE, Bousquet J, Huang S, Zhou X, Gul N, Hollis S, Gibbs M. Global Initiative for Asthma 2016-derived asthma control with fluticasone propionate and salmeterol: A Gaining Optimal Asthma Control (GOAL) study reanalysis. Ann Allergy Asthma Immunol 2019; 123:57-63.e2. [PMID: 31028894 DOI: 10.1016/j.anai.2019.04.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 03/22/2019] [Accepted: 04/17/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND In 2004, the landmark Gaining Optimal Asthma Control (GOAL) study demonstrated that most patients can achieve asthma control through sustained treatment and that adding a long-acting β2-adrenoreceptor agonist to an inhaled corticosteroid (ICS) is more effective than ICS alone in this regard. Definitions of asthma control have since evolved, and the consequent implications for the GOAL study findings are unclear. OBJECTIVE To evaluate the efficacy of fluticasone propionate and salmeterol and fluticasone propionate alone in achieving and maintaining asthma control, as derived from the Global Initiative for Asthma (GINA) 2016 report. METHODS In total, 3416 patients were stratified by prior medication (ICS-naive [stratum 1], low-dose ICS [stratum 2], or medium-dose ICS [stratum 3]) and randomized to receive fluticasone propionate and salmeterol or fluticasone propionate. The primary end point was the proportion of patients achieving well-controlled or partly controlled asthma; secondary end points included the proportion of patients achieving well-controlled asthma. Control was evaluated during the last 4 weeks of each dose titration. RESULTS In all strata, more patients achieved well-controlled or partly controlled asthma with fluticasone propionate and salmeterol vs fluticasone propionate alone (stratum 1: 91% vs 85%; P = .003; stratum 2: 86% vs 82%; P = .07; and stratum 3: 76% vs 66%; P < .001), as well as patients with well-controlled asthma (stratum 1: 64% vs 56%; P = .005; stratum 2: 59% vs 41%; P < .001; and stratum 3: 40% vs 22%; P < .001). CONCLUSION A markedly higher proportion of patients with uncontrolled asthma in each stratum achieved control according to GINA 2016 criteria compared with the original study criteria. The proportion of patients achieving control remained greater with fluticasone propionate and salmeterol than with fluticasone propionate alone.
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Affiliation(s)
- Eric D Bateman
- Division of Pulmonology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
| | - William Busse
- University of Wisconsin, School of Medicine and Public Health, Madison, Wisconsin
| | - Søren E Pedersen
- Pediatric Research Unit, University of Southern Denmark, Kolding Hospital, Kolding, Denmark
| | - Jean Bousquet
- Fondation MACVIA-LR, Contre les Maladies Chroniques pour un Vieillissement Actif en Languedoc-Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, University of Montpellier, Montpellier, France
| | - Shaoguang Huang
- Department of Respiratory Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xin Zhou
- Shanghai First People's Hospital, Shanghai, China
| | - Nadeem Gul
- Global Respiratory Franchise, GSK House, Brentford, Middlesex, United Kingdom
| | | | - Michael Gibbs
- Global Respiratory Franchise, GSK House, Brentford, Middlesex, United Kingdom
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Gunsoy NB, Bratton DJ, Albers FC, Busse W. Reply. J Allergy Clin Immunol 2019; 143:1267-1268. [PMID: 30639066 DOI: 10.1016/j.jaci.2018.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 11/16/2018] [Indexed: 11/25/2022]
Affiliation(s)
| | - Daniel J Bratton
- Clinical Statistics, GSK, Stockley Park, Uxbridge, United Kingdom
| | - Frank C Albers
- Respiratory Medical Franchise, GSK, Research Triangle Park, NC
| | - William Busse
- Department of Medicine, Allergy, Pulmonary and Critical Care Medicine, University of Wisconsin-Madison, Madison, Wis.
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Casale TB, Luskin AT, Busse W, Zeiger RS, Trzaskoma B, Yang M, Griffin NM, Chipps BE. Omalizumab Effectiveness by Biomarker Status in Patients with Asthma: Evidence From PROSPERO, A Prospective Real-World Study. The Journal of Allergy and Clinical Immunology: In Practice 2019; 7:156-164.e1. [DOI: 10.1016/j.jaip.2018.04.043] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 04/05/2018] [Accepted: 04/30/2018] [Indexed: 12/17/2022]
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34
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Corren J, Casale T, Haselkorn T, Yang M, Iqbal A, Ortiz B, Busse W. EFFECT OF OMALIZUMAB ON SEASONAL EXACERBATIONS IN ADOLESCENTS AND ADULTS WITH MODERATE-TO-SEVERE ALLERGIC ASTHMA. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Huang A, Swanson C, Babineau D, Whalen E, Gill M, Shao B, Liu A, Jepson B, Gruchalla R, O'Connor G, Pongracic J, Kercsmar C, Hershey GK, Zoratti E, Johnson C, Teach S, Kattan M, Bacharier L, Beigelman A, Sigelman S, Gergen P, Wheatley L, Presnell S, Togias A, Busse W, Jackson D, Altman M. EPITHELIAL CELL GENE NETWORKS UPREGULATED IN OBESE ASTHMATIC CHILDREN. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Busse W, Chupp G, Nagase H, Albers FC, Doyle S, Shen Q, Bratton DJ, Gunsoy NB. Anti-IL-5 treatments in patients with severe asthma by blood eosinophil thresholds: Indirect treatment comparison. J Allergy Clin Immunol 2018; 143:190-200.e20. [PMID: 30205189 DOI: 10.1016/j.jaci.2018.08.031] [Citation(s) in RCA: 153] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 08/24/2018] [Accepted: 08/31/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Three anti-IL-5 pathway-directed therapies are approved for use in patients with severe eosinophilic asthma (SEA); however, no head-to-head comparison data are available. OBJECTIVE We sought to compare the efficacy of licensed doses of mepolizumab, benralizumab, and reslizumab in patients with SEA, according to baseline blood eosinophil counts. METHODS This indirect treatment comparison (ITC) used data from a Cochrane review and independent searches. Eligible studies were randomized controlled trials in patients aged 12 years or greater with SEA. End points included annualized rate of clinically significant exacerbations and change from baseline in Asthma Control Questionnaire score and FEV1. An ITC was performed in patients with Asthma Control Questionnaire scores of 1.5 or greater and stratified by baseline blood eosinophil count. RESULTS Eleven studies were included. All treatments significantly reduced the rate of clinically significant exacerbations and improved asthma control versus placebo in all blood eosinophil count subgroups. Mepolizumab reduced clinically significant exacerbations by 34% to 45% versus benralizumab across subgroups (rate ratio ≥400 cells/μL: 0.55 [95% CI, 0.35-0.87]; ≥300 cells/μL: 0.61 [95% CI, 0.37-0.99]; and ≥150 cells/μL: 0.66 [95% CI, 0.49-0.89]; all P < .05) and by 45% versus reslizumab in the 400 cells/μL or greater subgroup (rate ratio, 0.55 [95% CI, 0.36-0.85]; P = .007). Asthma control was significantly improved with mepolizumab versus benralizumab (all subgroups: P < .05) and versus reslizumab in the 400 cells/μL or greater subgroup (P = .004). Benralizumab significantly improved lung function versus reslizumab in the 400 cells/μL or greater subgroup (P = .025). CONCLUSIONS This ITC of the licensed doses suggests that mepolizumab was associated with significantly greater improvements in clinically significant exacerbations and asthma control compared with reslizumab or benralizumab in patients with similar blood eosinophil counts.
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Affiliation(s)
- William Busse
- Department of Medicine, Allergy, Pulmonary and Critical Care Medicine, University of Wisconsin-Madison, Madison, Wis.
| | | | - Hiroyuki Nagase
- Teikyo University School of Medicine, Division of Respiratory Medicine and Allergology, Department of Medicine, Tokyo, Japan
| | - Frank C Albers
- Respiratory Medical Franchise, GlaxoSmithKline, Research Triangle Park, NC
| | - Scott Doyle
- Value Evidence & Outcomes, GlaxoSmithKline, Brentford, United Kingdom
| | - Qin Shen
- Analytics and Innovation, Value Evidence and Outcomes, GlaxoSmithKline, Upper Providence, Pa
| | - Daniel J Bratton
- Clinical Statistics, GlaxoSmithKline, Stockley Park, Uxbridge, United Kingdom
| | - Necdet B Gunsoy
- Value Evidence & Outcomes, GlaxoSmithKline, Brentford, United Kingdom
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Busse W, Janssens M, Eisen G, Us E, Busse CW, Creticos P, Dolovich J, Graft D, Knight A, Grant A, Cross G, Munk Z, Pauli B, Bronsky E, Meltzer EO, Nathan R, Nelson H, Seltzer J. A Multicenter, Double-Blind, Randomized, Placebo-Controlled Trial Comparing the Efficacy and Tolerability of Levocabastine-Oxymetazoline Nasal Spray with Levocabastine and Oxymetazoline Alone in the Symptomatic Treatment of Seasonal Allergic Rhinitis. ACTA ACUST UNITED AC 2018. [DOI: 10.2500/105065896781795076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A total of 1015 patients participated in three 1-week, multicenter, double-blind, randomized, placebo-controlled trials undertaken to assess the therapeutic efficacy and tolerability of twice daily administration of a nasal spray containing a combination of levocabastine (0.5 mg/mL) and oxymetazoline (0.5 mg/mL) (levocabastine-D) versus that of either agent alone in the treatment of ragweed-induced seasonal allergic rhinitis. As these studies shared a common protocol, the data have been pooled. Patient assessments revealed that the mean change in area under the curve (AUC) from baseline over the entire treatment period was significantly greater in patients treated with levocabastine or levocabastine-D than in those receiving placebo for all symptoms evaluated (nasal congestion; P < 0.05 and sneezing, rhinorrhea, nasal itching, ocular symptoms, total key symptoms, total all symptoms; P < 0.001). Corresponding changes in patients treated with oxymetazoline alone did not attain statistical significance. Day-by-day analysis demonstrated that the beneficial effects seen with levocabastine and levocabastine-D were maintained throughout the treatment period for all symptoms except nasal congestion (Days 1 and 2 only); oxymetazoline provided significant relief from nasal congestion only and only on the first day of treatment. Investigator assessments revealed similar trends. Global evaluations of therapeutic efficacy revealed that 44% of levocabastine-treated patients and 52% of patients treated with levocabastine-D considered therapeutic efficacy to be excellent or good compared with 39% of those on oxymetazoline and 26% on placebo (P < 0.01 versus placebo). Adverse experiences were reported by 30% of levocabastine-treated patients, 40% of patients treated with levocabastine-D and oxymetazoline, and 32% of placebo controls, with no statistically significant intergroup differences in incidence or type. In conclusion, twice daily levocabastine nasal spray is effective and well-tolerated for the treatment of ragweed-induced seasonal allergic rhinitis with an adverse effect profile comparable with that of placebo. Addition of oxymetazoline to the topical antihistamine does not appear to provide significant additional clinical benefit compared to that observed with levocabastine alone, and tachyphylaxis to the decongestant effect of the topical vasoconstrictor occurs within days of treatment initiation.
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Affiliation(s)
- William Busse
- University of Wisconsin, Madison Medical School, Beerse, Belgium
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Bousquet J, Barnes N, Gibbs M, Gul N, Tomkins SA, Zhou X, Cho YJ, Park HS, Busse W, Zhong N. Asthma control using fluticasone propionate/salmeterol in Asian and non-Asian populations: a post hoc analysis of the GOAL study. BMC Pulm Med 2017; 17:75. [PMID: 28454528 PMCID: PMC5410062 DOI: 10.1186/s12890-017-0410-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 04/11/2017] [Indexed: 11/10/2022] Open
Abstract
Background To analyse the efficacy of fluticasone propionate (FP) alone and combined with salmeterol (SAL) in achieving guideline-defined asthma control in Asian patients. Methods A post hoc analysis of the GOAL study in which patients were stratified by prior-medication use into inhaled corticosteroid (ICS)-naïve (Stratum [S] 1), low-dose ICS (S2), and medium-dose ICS (S3), and randomised to receive FP/SAL or FP. Doses were stepped-up every 12 weeks until Totally Controlled asthma or maximum dose was reached (PhI) and then maintained until study end (PhII). The primary endpoint was the proportion of patients achieving Well-Controlled asthma during PhI. Additional endpoints included Total Control and adverse events. Asian and non-Asian patients were analysed separately. Results In Asian patients in PhI, 74% (n = 87/118) in S1 achieved Well-Controlled asthma with FP/SAL versus 74% (n = 89/121) with FP alone (p = 0.839); corresponding values were 76% (n = 81/107) versus 60% (n = 62/104; p = 0.005) in S2, and 58% (n = 59/102) versus 43% (n = 41/95; p = 0.015) in S3. More patients in all three strata achieved Totally Controlled asthma with FP/SAL versus FP alone. Control was achieved more rapidly and with lower ICS doses with FP/SAL versus FP. A high proportion of patients who achieved control during PhI maintained control during PhII. Similar trends were found in non-Asian patients. No new safety concerns were identified. Conclusions A greater proportion of Asian patients (S2 and S3, for Well-Controlled; all strata, for Totally Controlled) achieved guideline-defined asthma control with FP/SAL versus FP alone. High proportions of Asian patients in S1 achieved Well-Controlled asthma in both treatment groups. Electronic supplementary material The online version of this article (doi:10.1186/s12890-017-0410-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jean Bousquet
- Fondation MACVIA-LR, Contre les Maladies Chroniques pour un Vieillissement Actif en Languedoc-Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, University of Montpellier, Montpellier, France. .,INSERM, VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches, U1168, Paris, France. .,UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Paris, France.
| | - Neil Barnes
- Global Respiratory Franchise, GSK House, Brentford, Middlesex, UK.,William Harvey Institute, Barts and the London School of Medicine and Dentistry, London, UK
| | - Michael Gibbs
- Global Respiratory Franchise, GSK House, Brentford, Middlesex, UK
| | - Nadeem Gul
- Quantitative Science, Clinical Statistics, GSK, Stockley Park, Middlesex, UK
| | - Susan A Tomkins
- Quantitative Science, Clinical Statistics, GSK, Stockley Park, Middlesex, UK
| | - Xin Zhou
- Shanghai First People's Hospital, Shanghai, China
| | - Young-Joo Cho
- Ewha Womans University, School of Medicine, Seoul, South Korea
| | - Hae-Sim Park
- Ajou University Medical Center, Suwon, South Korea
| | - William Busse
- University of Wisconsin, School of Medicine and Public Health, Madison, WI, USA
| | - Nanshan Zhong
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Szefler SJ, Casale TB, Rosén K, Trzaskoma BL, Haselkorn T, Ortiz B, Busse W. Baseline Blood Eosinophils and Reduction of Asthma Exacerbations By Omalizumab in Children with Moderate-to-Severe Allergic Asthma. J Allergy Clin Immunol 2017. [DOI: 10.1016/j.jaci.2016.12.223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gonzalez-Reyes EG, Luskin AT, Busse W, Casale TB, Chipps BE, Antonova E, Limb SL, Trzaskoma BL, Griffin NM, Zeiger RS. Clinically Significant Improvements in Asthma Patient-Reported Outcomes: Results from the Prospective Observational Study to Evaluate Predictors of Clinical Effectiveness in Response to Omalizumab (PROSPERO) Study. J Allergy Clin Immunol 2017. [DOI: 10.1016/j.jaci.2016.12.084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Chipps BW, Busse W, Luskin AT, Zeiger RS, Trzaskoma BL, Griffin NM, Antonova E, Limb SL, Casale TB. Decreased Asthma Exacerbations and Hospitalizations in PROSPERO (Prospective Study to Evaluate Predictors of Clinical Effectiveness in Response to Omalizumab). J Allergy Clin Immunol 2017. [DOI: 10.1016/j.jaci.2016.12.080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ledford D, Busse W, Trzaskoma B, Omachi TA, Rosén K, Chipps BE, Luskin AT, Solari PG. A randomized multicenter study evaluating Xolair persistence of response after long-term therapy. J Allergy Clin Immunol 2016; 140:162-169.e2. [PMID: 27826098 DOI: 10.1016/j.jaci.2016.08.054] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 08/09/2016] [Accepted: 08/25/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Few data are available to assist clinicians with decisions regarding long-term use of asthma therapies, including omalizumab. OBJECTIVE We sought to evaluate the benefit and persistence of response in subjects continuing or withdrawing from long-term omalizumab treatment. METHODS Evaluating the Xolair Persistency Of Response After Long-Term Therapy (XPORT) was a randomized, double-blind, placebo-controlled withdrawal study that included subjects with moderate-to-severe persistent asthma receiving long-term omalizumab. Subjects were randomized by using a hierarchical dynamic randomization scheme to continue their same dose of omalizumab or withdraw to placebo and were then followed every 4 weeks for 1 year. The primary outcome was any protocol-defined severe asthma exacerbation. The secondary outcome was time to first protocol-defined severe asthma exacerbation. Exploratory outcomes included changes in Asthma Control Questionnaire and Asthma Control Test scores. RESULTS Significantly more subjects in the omalizumab group (67%) had no protocol-defined exacerbation than in the placebo group (47.7%); an absolute difference of 19.3% (95% CI, 5.0%, 33.6%) represents a 40.1% relative difference. Time to first protocol-defined exacerbation analysis revealed a significantly different between-group exacerbation pattern that was consistent with the primary analysis. Subjects continuing omalizumab had significantly better asthma control (mean [SD] change from baseline to week 52: Asthma Control Test score, -1.16 [4.14] vs placebo, -2.88 [5.38], P = .0188; Asthma Control Questionnaire score, 0.22 [0.66] vs placebo, 0.63 [1.13], P = .0039). Discontinuation of omalizumab was associated with an increase in free IgE levels and an increase in basophil expression of the high-affinity IgE receptor. No safety concerns were noted. CONCLUSION Continuation of omalizumab after long-term treatment results in continued benefit, as evidenced by improved symptom control and reduced exacerbation risk.
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Affiliation(s)
- Dennis Ledford
- Morsani College of Medicine and James A. Haley VA Hospital, University of South Florida, Tampa, Fla.
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Chervinsky P, Meltzer EO, Busse W, Ohta K, Bardin P, Bredenbröker D, Bateman ED. Roflumilast for asthma: Safety findings from a pooled analysis of ten clinical studies. Pulm Pharmacol Ther 2015; 35 Suppl:S28-34. [PMID: 26612545 DOI: 10.1016/j.pupt.2015.11.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 11/13/2015] [Accepted: 11/17/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND The safety profile of roflumilast, a phosphodiesterase 4 inhibitor, has been extensively researched in patients with chronic obstructive pulmonary disease (COPD). Adverse events (AEs) including headache, diarrhoea and weight loss have been reported. Much less is known about the safety of roflumilast treatment in patients with bronchial asthma. AIM To evaluate the safety and tolerability of roflumilast using safety data from one open-label and ten pooled placebo-controlled phase II and III clinical studies completed between 1997 and 2005. SUBJECTS AND METHODS The studies were conducted at sites in Europe, North and South America, Africa, Australasia and Asia and study length varied from 4 to 40 weeks. Data for 5169 patients between 12 and 70 years of age, of whom 2851 received roflumilast at doses of 125, 250 and 500 μg, were analyzed. At randomization patients had a forced expiratory flow of 45-100%. RESULTS Headache was the most frequent AE with an incidence rate of 50 and 29.2 per 100 patient-years in the 500 μg roflumilast and placebo groups, respectively. Gastrointestinal AEs were common. Nausea and diarrhoea occurred in 28.7 and 28.3 per 100 patient-years in the 500 μg roflumilast and placebo groups, respectively. The extent of weight loss in roflumilast-treated patients was small. AEs reported in 465 patients in the 4-week open-label follow-up study reflected those of the pooled studies. CONCLUSIONS The severity and incidence of AEs reported from this pooled safety analysis confirm that roflumilast is generally well tolerated by patients with asthma. This reflects the general safety profile reported previously in patients with COPD. All studies were funded by Takeda. Trial registration numbers available on ClinicalTrials.gov: NCT00073177, NCT00076076, NCT00163527.
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Affiliation(s)
- P Chervinsky
- Northeast Medical Research Associates, Dartmouth, MD, USA.
| | - E O Meltzer
- Department of Pediatrics, Division of Allergy and Immunology, University of California, San Diego, CA, USA.
| | - W Busse
- Division of Allergy and Immunology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
| | - K Ohta
- Department of Respiratory Medicine and Allergology, Tokyo National Hospital, Tokyo, Japan.
| | - P Bardin
- Monash Lung & Sleep, Monash Medical Center and University, Victoria, Australia.
| | - D Bredenbröker
- Takeda Pharmaceuticals International GmbH, Zurich, Switzerland.
| | - E D Bateman
- Division of Pulmonology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
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Marozkina NV, Wang XQ, Stsiapura V, Fitzpatrick A, Carraro S, Hawkins GA, Bleecker E, Meyers D, Jarjour N, Fain SB, Wenzel S, Busse W, Castro M, Panettieri RA, Moore W, Lewis SJ, Palmer LA, Altes T, de Lange EE, Erzurum S, Teague WG, Gaston B. Phenotype of asthmatics with increased airway S-nitrosoglutathione reductase activity. Eur Respir J 2014; 45:87-97. [PMID: 25359343 DOI: 10.1183/09031936.00042414] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
S-Nitrosoglutathione is an endogenous airway smooth muscle relaxant. Increased airway S-nitrosoglutathione breakdown occurs in some asthma patients. We asked whether patients with increased airway catabolism of this molecule had clinical features that distinguished them from other asthma patients. We measured S-nitrosoglutathione reductase expression and activity in bronchoscopy samples taken from 66 subjects in the Severe Asthma Research Program. We also analysed phenotype and genotype data taken from the program as a whole. Airway S-nitrosoglutathione reductase activity was increased in asthma patients (p=0.032). However, only a subpopulation was affected and this subpopulation was not defined by a "severe asthma" diagnosis. Subjects with increased activity were younger, had higher IgE and an earlier onset of symptoms. Consistent with a link between S-nitrosoglutathione biochemistry and atopy: 1) interleukin 13 increased S-nitrosoglutathione reductase expression and 2) subjects with an S-nitrosoglutathione reductase single nucleotide polymorphism previously associated with asthma had higher IgE than those without this single nucleotide polymorphism. Expression was higher in airway epithelium than in smooth muscle and was increased in regions of the asthmatic lung with decreased airflow. An early-onset, allergic phenotype characterises the asthma population with increased S-nitrosoglutathione reductase activity.
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Affiliation(s)
- Nadzeya V Marozkina
- Dept of Paediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA
| | - Xin-Qun Wang
- Dept of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Vitali Stsiapura
- Dept of Chemistry, University of Virginia, Charlottesville, VA, USA
| | | | | | | | - Eugene Bleecker
- Dept of Medicine, Wake Forest University, Winston-Salem, NC, USA
| | - Deborah Meyers
- Dept of Medicine, Wake Forest University, Winston-Salem, NC, USA
| | - Nizar Jarjour
- Dept of Medicine, University of Wisconsin, Madison, WI, USA
| | - Sean B Fain
- Dept of Medical Physics, University of Wisconsin, Madison, WI, USA
| | | | - William Busse
- Dept of Medicine, University of Wisconsin, Madison, WI, USA
| | - Mario Castro
- Dept of Medicine, Washington University, St. Louis, MO, USA
| | - Reynold A Panettieri
- Pulmonary, Allergy and Critical Care Division, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Wendy Moore
- Dept of Medicine, Wake Forest University, Winston-Salem, NC, USA
| | - Stephen J Lewis
- Dept of Paediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA
| | - Lisa A Palmer
- Dept of Paediatrics, University of Virginia, Charlottesville, VA, USA
| | - Talissa Altes
- Dept of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, USA
| | - Eduard E de Lange
- Dept of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, USA
| | - Serpil Erzurum
- Dept of Pathobiology, Cleveland Clinic, Cleveland, OH, USA Dept of Pulmonary, Allergy, and Critical Care Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - W Gerald Teague
- Dept of Paediatrics, University of Virginia, Charlottesville, VA, USA
| | - Benjamin Gaston
- Dept of Paediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA
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Witt CA, Sheshadri A, Carlstrom L, Tarsi J, Kozlowski J, Wilson B, Gierada DS, Hoffman E, Fain SB, Cook-Granroth J, Sajol G, Sierra O, Giri T, O'Neill M, Zheng J, Schechtman KB, Bacharier LB, Jarjour N, Busse W, Castro M. Longitudinal changes in airway remodeling and air trapping in severe asthma. Acad Radiol 2014; 21:986-93. [PMID: 25018070 DOI: 10.1016/j.acra.2014.05.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 04/27/2014] [Accepted: 05/07/2014] [Indexed: 10/25/2022]
Abstract
RATIONALE AND OBJECTIVES Previous cross-sectional studies have demonstrated that airway wall thickness and air trapping are greater in subjects with severe asthma than in those with mild-to-moderate asthma. However, a better understanding of how airway remodeling and lung density change over time is needed. This study aimed to evaluate predictors of airway wall remodeling and change in lung function and lung density over time in severe asthma. MATERIALS AND METHODS Phenotypic characterization and quantitative multidetector-row computed tomography (MDCT) of the chest were performed at baseline and ∼2.6 years later in 38 participants with asthma (severe n = 24 and mild-to-moderate n = 14) and nine normal controls from the Severe Asthma Research Program. RESULTS Subjects with severe asthma had a significant decline in postbronchodilator forced expiratory volume in 1 second percent (FEV1%) predicted over time (P < .001). Airway wall thickness measured by MDCT was increased at multiple airway generations in severe asthma compared to mild-to-moderate asthma (wall area percent [WA%]: P < .05) and normals (P < .05) at baseline and year 2. Over time, there was an increase in WA% and wall thickness percent (WT%) in all subjects (P = .030 and .009, respectively) with no change in emphysema-like lung or air trapping. Baseline prebronchodilator FEV1% inversely correlated with WA% and WT% (both P < .05). In a multivariable regression model, baseline WA%, race, and health care utilization were predictors of subsequent airway remodeling. CONCLUSIONS Severe asthma subjects have a greater decline in lung function over time than normal subjects or those with mild-to-moderate asthma. MDCT provides a noninvasive measure of airway wall thickness that may predict subsequent airway remodeling.
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Rosén K, Busse W. Reply: To PMID 23591271. J Allergy Clin Immunol 2014; 133:1231. [PMID: 24679473 DOI: 10.1016/j.jaci.2014.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 01/15/2014] [Indexed: 10/25/2022]
Affiliation(s)
| | - William Busse
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis
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Zein J, Comhair S, Bleecker E, Busse W, Calhoun W, Castro M, Chung KF, Dweik R, Fitzpatrick A, Gaston B, Israel E, Jarjour N, Moore W, Teague G, Wenzel S, Erzurum S. The Effect of Aging and Menopause on Asthma Severity in Women. Chest 2014. [DOI: 10.1378/chest.1783148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Buehring B, Viswanathan R, Binkley N, Busse W. Glucocorticoid-induced osteoporosis: an update on effects and management. J Allergy Clin Immunol 2014; 132:1019-30. [PMID: 24176682 DOI: 10.1016/j.jaci.2013.08.040] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 08/30/2013] [Accepted: 08/30/2013] [Indexed: 12/25/2022]
Abstract
Glucocorticoids remain a cornerstone of guideline-based management of persistent asthma and allergic diseases. Glucocorticoid-induced osteoporosis (GIO) is the most common iatrogenic cause of secondary osteoporosis and an issue of concern for physicians treating patients with inhaled or oral glucocorticoids either continuously or intermittently. Patients with GIO experience fragility fractures at better dual-energy x-ray absorptiometry T-scores than those with postmenopausal or age-related osteoporosis. This might be explained, at least in part, by the effects of glucocorticoids not only on osteoclasts but also on osteoblasts and osteocytes. Effective options to detect and manage GIO exist, and a management algorithm has been published by the American College of Rheumatology to provide treatment guidance for clinicians. This review will summarize GIO epidemiology and pathophysiology and assess the role of inhaled and oral glucocorticoids in asthmatic adults and children, with particular emphasis on the effect of such therapies on bone health. Lastly, we will review the American College of Rheumatology GIO guidelines and discuss diagnostic and therapeutic strategies to mitigate the risk of GIO and fragility fractures.
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Affiliation(s)
- Bjoern Buehring
- University of Wisconsin Osteoporosis Research Program, Division of Geriatrics and Gerontology, University of Wisconsin School of Medicine & Public Health, Madison, Wis; GRECC, William S. Middleton Memorial Veterans Hospital, Madison, Wis.
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Wysocki K, Park SY, Bleecker E, Busse W, Castro M, Chung KF, Gaston B, Erzurum S, Israel E, Teague WG, Moore CG, Wenzel S. Characterization of factors associated with systemic corticosteroid use in severe asthma: data from the Severe Asthma Research Program. J Allergy Clin Immunol 2013; 133:915-8. [PMID: 24332222 DOI: 10.1016/j.jaci.2013.10.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Revised: 10/16/2013] [Accepted: 10/29/2013] [Indexed: 11/28/2022]
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Hanania NA, Wenzel S, Rosén K, Hsieh HJ, Mosesova S, Choy DF, Lal P, Arron JR, Harris JM, Busse W. Exploring the effects of omalizumab in allergic asthma: an analysis of biomarkers in the EXTRA study. Am J Respir Crit Care Med 2013; 187:804-11. [PMID: 23471469 DOI: 10.1164/rccm.201208-1414oc] [Citation(s) in RCA: 631] [Impact Index Per Article: 57.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE For many patients with asthma, allergic airway inflammation is primarily a Th2-weighted process; however, heterogeneity in patterns of inflammation suggests phenotypic distinctions exist that influence disease presentation and treatment effects. OBJECTIVES To assess the potential of fractional exhaled nitric oxide (FE(NO)), peripheral blood eosinophil count, and serum periostin as biomarkers of Th2 inflammation and predictors of treatment effects of omalizumab. METHODS The EXTRA omalizumab study enrolled patients (aged 12-75 yr) with uncontrolled severe persistent allergic asthma. Analyses were performed evaluating treatment effects in relation to FE(NO), blood eosinophils, and serum periostin at baseline. Patients were divided into low- and high-biomarker subgroups. Treatment effects were evaluated as number of protocol-defined asthma exacerbations during the 48-week treatment period (primary endpoint). MEASUREMENTS AND MAIN RESULTS A total of 850 patients were enrolled. Data were available from 394 (46.4%), 797 (93.8%), and 534 (62.8%) patients for FE(NO), blood eosinophils, and serum periostin, respectively. After 48 weeks of omalizumab, reductions in protocol-defined exacerbations were greater in high versus low subgroups for all three biomarkers: FE(NO), 53% (95% confidence interval [CI], 37-70; P = 0.001) versus 16% (95% CI, -32 to 46; P = 0.45); eosinophils, 32% (95% CI, 11-48; P = 0.005) versus 9% (95% CI, -24 to 34; P = 0.54); and periostin, 30% (95% CI, -2 to 51; P = 0.07) versus 3% (95% CI, -43 to 32; P = 0.94). CONCLUSIONS The difference in exacerbation frequency between omalizumab and placebo was greatest in the three high-biomarker subgroups, probably associated with the greater risk for exacerbations in high subgroups. Additional studies are required to explore the value of these biomarkers in clinical practice. Clinical trial registered with www.clinicaltrials.gov (NCT00314574).
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Affiliation(s)
- Nicola A Hanania
- Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, TX, USA
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