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Impact of biologics on lung hyperinflation in patients with severe asthma
In asthma, inflammation affects both the proximal and distal airways and can cause significant hyperinflation, which is thought to be a major cause of dyspnea. This is a retrospective observational study evaluating the effect of three months of treatment with different biologic drugs (benralizumab,...
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| Published in: | Respiratory medicine 2024-04, Vol.225, p.107578-107578, Article 107578 |
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| container_title | Respiratory medicine |
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| creator | Maniscalco, Mauro Candia, Claudio Calabrese, Cecilia D'Amato, Maria Matera, Maria Gabriella Molino, Antonio Cazzola, Mario |
| description | In asthma, inflammation affects both the proximal and distal airways and can cause significant hyperinflation, which is thought to be a major cause of dyspnea.
This is a retrospective observational study evaluating the effect of three months of treatment with different biologic drugs (benralizumab, dupilumab and omalizumab) on pulmonary hyperinflation in a cohort of patients with severe asthma already receiving regular triple inhaled therapy. Changes in RV, RV/TLC ratio, FRC and FRC/TLC ratio were the primary efficacy measures. Secondary outcomes included FEV1, FVC, FEV1/FVC ratio, IC, IC/TLC ratio, asthma control test, the percentage of eosinophils in the blood and fractional FENO.
Benralizumab led to significant changes (p |
| doi_str_mv | 10.1016/j.rmed.2024.107578 |
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This is a retrospective observational study evaluating the effect of three months of treatment with different biologic drugs (benralizumab, dupilumab and omalizumab) on pulmonary hyperinflation in a cohort of patients with severe asthma already receiving regular triple inhaled therapy. Changes in RV, RV/TLC ratio, FRC and FRC/TLC ratio were the primary efficacy measures. Secondary outcomes included FEV1, FVC, FEV1/FVC ratio, IC, IC/TLC ratio, asthma control test, the percentage of eosinophils in the blood and fractional FENO.
Benralizumab led to significant changes (p < 0.001) in RV, RV/TLC, FRC, and FRC/TLC. Dupilumab demonstrated a notable reduction in RV (p = 0.017) and RV/TLC (p = 0.002), but the decreases in FRC and FRC/TLC were merely numerical and not as pronounced as those induced by benralizumab. Omalizumab's positive impact on RV (p = 0.057) and RV/TLC (p = 0.085), as well as FRC (p = 0.202) and FRC/TLC (p = 0.096), was also predominantly numerical, with a tendency towards efficacy, albeit excluding the effect on FRC. Treatment with biologics resulted in improvements in all other lung function parameters assessed and a decrease in FENO levels.
This study, although limited by small sample size, lack of a placebo control, and unbalanced group sizes, suggests that biological agents are effective in reducing lung hyperinflation even after a relatively short treatment.
•Lung hyperinflation frequently occurs in patients with moderate to severe asthma.•Treatment of the small airways is essential to reduce lung hyperinflation.•Biologics are effective in reducing lung hyperinflation even after a relatively short treatment.•Our results would suggest that biologics may have a beneficial effect on SAD over time.</description><identifier>ISSN: 0954-6111</identifier><identifier>EISSN: 1532-3064</identifier><identifier>DOI: 10.1016/j.rmed.2024.107578</identifier><identifier>PMID: 38431058</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Asthma - drug therapy ; Biological Products - therapeutic use ; Biologics ; Forced Expiratory Volume ; Humans ; Lung ; Lung hyperinflation ; Omalizumab - therapeutic use ; Severe asthma</subject><ispartof>Respiratory medicine, 2024-04, Vol.225, p.107578-107578, Article 107578</ispartof><rights>2024 The Authors</rights><rights>Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-891db0c8e9e78a0530d8f8a9eca5fad78563b01e3b3d81624be7c252cc41275c3</citedby><cites>FETCH-LOGICAL-c356t-891db0c8e9e78a0530d8f8a9eca5fad78563b01e3b3d81624be7c252cc41275c3</cites><orcidid>0000-0001-6751-9921 ; 0000-0002-5888-8781 ; 0000-0003-4895-9707</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38431058$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Maniscalco, Mauro</creatorcontrib><creatorcontrib>Candia, Claudio</creatorcontrib><creatorcontrib>Calabrese, Cecilia</creatorcontrib><creatorcontrib>D'Amato, Maria</creatorcontrib><creatorcontrib>Matera, Maria Gabriella</creatorcontrib><creatorcontrib>Molino, Antonio</creatorcontrib><creatorcontrib>Cazzola, Mario</creatorcontrib><title>Impact of biologics on lung hyperinflation in patients with severe asthma</title><title>Respiratory medicine</title><addtitle>Respir Med</addtitle><description>In asthma, inflammation affects both the proximal and distal airways and can cause significant hyperinflation, which is thought to be a major cause of dyspnea.
This is a retrospective observational study evaluating the effect of three months of treatment with different biologic drugs (benralizumab, dupilumab and omalizumab) on pulmonary hyperinflation in a cohort of patients with severe asthma already receiving regular triple inhaled therapy. Changes in RV, RV/TLC ratio, FRC and FRC/TLC ratio were the primary efficacy measures. Secondary outcomes included FEV1, FVC, FEV1/FVC ratio, IC, IC/TLC ratio, asthma control test, the percentage of eosinophils in the blood and fractional FENO.
Benralizumab led to significant changes (p < 0.001) in RV, RV/TLC, FRC, and FRC/TLC. Dupilumab demonstrated a notable reduction in RV (p = 0.017) and RV/TLC (p = 0.002), but the decreases in FRC and FRC/TLC were merely numerical and not as pronounced as those induced by benralizumab. Omalizumab's positive impact on RV (p = 0.057) and RV/TLC (p = 0.085), as well as FRC (p = 0.202) and FRC/TLC (p = 0.096), was also predominantly numerical, with a tendency towards efficacy, albeit excluding the effect on FRC. Treatment with biologics resulted in improvements in all other lung function parameters assessed and a decrease in FENO levels.
This study, although limited by small sample size, lack of a placebo control, and unbalanced group sizes, suggests that biological agents are effective in reducing lung hyperinflation even after a relatively short treatment.
•Lung hyperinflation frequently occurs in patients with moderate to severe asthma.•Treatment of the small airways is essential to reduce lung hyperinflation.•Biologics are effective in reducing lung hyperinflation even after a relatively short treatment.•Our results would suggest that biologics may have a beneficial effect on SAD over time.</description><subject>Asthma - drug therapy</subject><subject>Biological Products - therapeutic use</subject><subject>Biologics</subject><subject>Forced Expiratory Volume</subject><subject>Humans</subject><subject>Lung</subject><subject>Lung hyperinflation</subject><subject>Omalizumab - therapeutic use</subject><subject>Severe asthma</subject><issn>0954-6111</issn><issn>1532-3064</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kMtOwzAQRS0EoqXwAyyQl2xS_IgTR2KDKh6VKrGBteU4k9ZVXthJUf8eR2m3rGY0c-8dzUHonpIlJTR52i9dDcWSERaHQSpSeYHmVHAWcZLEl2hOMhFHCaV0hm683xNCsjgm12jGZcwpEXKO1uu606bHbYlz21bt1hqP2wZXQ7PFu2MHzjZlpXsbZrbBXeig6T3-tf0OeziAA6x9v6v1LboqdeXh7lQX6Pvt9Wv1EW0-39erl01kuEj6SGa0yImRkEEqNRGcFLKUOgOjRamLVIqE54QCz3khacLiHFLDBDMmpiwVhi_Q45TbufZnAN-r2noDVaUbaAevWMZTHk6RNEjZJDWu9d5BqTpna-2OihI1IlR7NSJUI0I1IQymh1P-kI-7s-XMLAieJwGELw8WnPImQDFQWAemV0Vr_8v_A9ZyglE</recordid><startdate>202404</startdate><enddate>202404</enddate><creator>Maniscalco, Mauro</creator><creator>Candia, Claudio</creator><creator>Calabrese, Cecilia</creator><creator>D'Amato, Maria</creator><creator>Matera, Maria Gabriella</creator><creator>Molino, Antonio</creator><creator>Cazzola, Mario</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6751-9921</orcidid><orcidid>https://orcid.org/0000-0002-5888-8781</orcidid><orcidid>https://orcid.org/0000-0003-4895-9707</orcidid></search><sort><creationdate>202404</creationdate><title>Impact of biologics on lung hyperinflation in patients with severe asthma</title><author>Maniscalco, Mauro ; Candia, Claudio ; Calabrese, Cecilia ; D'Amato, Maria ; Matera, Maria Gabriella ; Molino, Antonio ; Cazzola, Mario</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-891db0c8e9e78a0530d8f8a9eca5fad78563b01e3b3d81624be7c252cc41275c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Asthma - drug therapy</topic><topic>Biological Products - therapeutic use</topic><topic>Biologics</topic><topic>Forced Expiratory Volume</topic><topic>Humans</topic><topic>Lung</topic><topic>Lung hyperinflation</topic><topic>Omalizumab - therapeutic use</topic><topic>Severe asthma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Maniscalco, Mauro</creatorcontrib><creatorcontrib>Candia, Claudio</creatorcontrib><creatorcontrib>Calabrese, Cecilia</creatorcontrib><creatorcontrib>D'Amato, Maria</creatorcontrib><creatorcontrib>Matera, Maria Gabriella</creatorcontrib><creatorcontrib>Molino, Antonio</creatorcontrib><creatorcontrib>Cazzola, Mario</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Respiratory medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Maniscalco, Mauro</au><au>Candia, Claudio</au><au>Calabrese, Cecilia</au><au>D'Amato, Maria</au><au>Matera, Maria Gabriella</au><au>Molino, Antonio</au><au>Cazzola, Mario</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of biologics on lung hyperinflation in patients with severe asthma</atitle><jtitle>Respiratory medicine</jtitle><addtitle>Respir Med</addtitle><date>2024-04</date><risdate>2024</risdate><volume>225</volume><spage>107578</spage><epage>107578</epage><pages>107578-107578</pages><artnum>107578</artnum><issn>0954-6111</issn><eissn>1532-3064</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><notes>ObjectType-Undefined-3</notes><abstract>In asthma, inflammation affects both the proximal and distal airways and can cause significant hyperinflation, which is thought to be a major cause of dyspnea.
This is a retrospective observational study evaluating the effect of three months of treatment with different biologic drugs (benralizumab, dupilumab and omalizumab) on pulmonary hyperinflation in a cohort of patients with severe asthma already receiving regular triple inhaled therapy. Changes in RV, RV/TLC ratio, FRC and FRC/TLC ratio were the primary efficacy measures. Secondary outcomes included FEV1, FVC, FEV1/FVC ratio, IC, IC/TLC ratio, asthma control test, the percentage of eosinophils in the blood and fractional FENO.
Benralizumab led to significant changes (p < 0.001) in RV, RV/TLC, FRC, and FRC/TLC. Dupilumab demonstrated a notable reduction in RV (p = 0.017) and RV/TLC (p = 0.002), but the decreases in FRC and FRC/TLC were merely numerical and not as pronounced as those induced by benralizumab. Omalizumab's positive impact on RV (p = 0.057) and RV/TLC (p = 0.085), as well as FRC (p = 0.202) and FRC/TLC (p = 0.096), was also predominantly numerical, with a tendency towards efficacy, albeit excluding the effect on FRC. Treatment with biologics resulted in improvements in all other lung function parameters assessed and a decrease in FENO levels.
This study, although limited by small sample size, lack of a placebo control, and unbalanced group sizes, suggests that biological agents are effective in reducing lung hyperinflation even after a relatively short treatment.
•Lung hyperinflation frequently occurs in patients with moderate to severe asthma.•Treatment of the small airways is essential to reduce lung hyperinflation.•Biologics are effective in reducing lung hyperinflation even after a relatively short treatment.•Our results would suggest that biologics may have a beneficial effect on SAD over time.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>38431058</pmid><doi>10.1016/j.rmed.2024.107578</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0001-6751-9921</orcidid><orcidid>https://orcid.org/0000-0002-5888-8781</orcidid><orcidid>https://orcid.org/0000-0003-4895-9707</orcidid><oa>free_for_read</oa></addata></record> |
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| source | ScienceDirect Journals |
| subjects | Asthma - drug therapy Biological Products - therapeutic use Biologics Forced Expiratory Volume Humans Lung Lung hyperinflation Omalizumab - therapeutic use Severe asthma |
| title | Impact of biologics on lung hyperinflation in patients with severe asthma |
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