Longitudinal multi-trajectory phenotypes of severe eosinophilic asthma on type 2 biologics treatment
Year: 2024
Type: article
Study design: Observational Study
Abstract: Background Limited understanding exists regarding the progression trajectory of severe eosinophilic asthma (SEA) patients on type 2 biologics therapies. Objective We aim to explore distinct longitudinal phenotypes of these patients based on crucial asthma biomarkers. Methods We enrolled 101 adult patients with SEA. Of these, 51 were treated with anti-IL5/IL5Rα or anti-IL5/IL5RαR antibody, and 50 with anti-IL-4Rα antibody. Multi-trajectory analysis, an extension of univariate group-based trajectory modeling, was used to categorize patients based on their trajectories of forced expiratory volume in 1 s (FEV 1 ), blood eosinophil counts (BEC), and fractional exhaled nitric oxide (FeNO) levels at baseline, and after 1, 6, and 12 months of treatment. Associations between trajectory-based clusters and clinical parameters were examined. Results Among anti-IL5/IL5Rα antibody-treated patients, 2 clusters were identified. The cluster characterized by higher baseline BEC and lower FEV 1 showed a better response, with improvements in FEV 1 and reductions in BEC over time. Among anti-IL-4Rα antibody-treated, 3 clusters were identified. Clusters with moderate BEC and FeNO at baseline demonstrated better improvements in FEV 1 and reductions in FeNO, despite increased BEC during follow-up. Conversely, individuals with extremely low FeNO and high BEC at baseline were more likely to experience poorer progression, demonstrating an increase in FeNO and a reduction in FEV 1 . Conclusion To optimally monitor treatment response in SEA patients on type 2 biologics, integrating longitudinal biomarker features is essential.
Authors: Duong Duc Pham,, Ji-Hyang Lee,, Hyouk-Soo Kwon,, Woo-Jung Song,, You Sook Cho,, Hyunkyoung Kim,, Jae-Woo Kwon,, So-Young Park,, Sujeong Kim,, Gyu Young Hur,, Byung Keun Kim,, Young-Hee Nam,, Min-Suk Yang,, Mi-Yeong Kim,, Sae-Hoon Kim,, Byung-Jae Lee,, Taehoon Lee,, So Young Park,, Min-Hye Kim,, Young-Joo Cho,, ChanSun Park,, Jae-Woo Jung,, Han Ki Park,, Joo-Hee Kim,, Ji-Yong Moon,, Pankaj Bhavsar, Ian M. Adcock,, Kian Fan Chung,, Tae-Bum Kim,
Institutions: Asan Medical Center, University of Ulsan, Ewha Womans University, Ewha Womans University Mokdong Hospital, Kangwon National University, Eulji University, Eulji Medical Center, Chung-Ang University Gwangmyeong Hospital, Seoul National University, Seoul National University Bundang Hospital, Kyungpook National University, Korea University, Korea University Medical Center, Korea University Anam Hospital, Dong-A University, Seoul Metropolitan Government, SNUH SMG-SNU Boramae Medical Center, Inje University, Inje University Busan Paik Hospital, Ewha Womans University Medical Center, Samsung Medical Center, Sungkyunkwan University, Ulsan University Hospital, Inje University Haeundae Paik Hospital, Chung-Ang University, Kyungpook National University Chilgok Hospital, Hallym University Sacred Heart Hospital, Hanyang University, Imperial College London
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,640
Awards: G7152094987, G8919290429
OpenAlex ID: W4404591139