Switch from IL-5 to IL-5-Receptor alpha Antibody Treatment in Severe Eosinophilic Asthma

Drick, Nora; Milger, Katrin; Seeliger, Benjamin; Fuge, Jan; Korn, Stephanie; Buhl, Roland; Schuhmann, Maren; Herth, Felix; Kendziora, Benjamin; Behr, Jürgen; Kneidinger, Nikolaus; Bergmann, Karl-Christian; Taube, Christian; Welte, Tobias und Suhling, Hendrik (2020): Switch from IL-5 to IL-5-Receptor alpha Antibody Treatment in Severe Eosinophilic Asthma. In: Journal of Asthma and Allergy, Bd. 13: S. 605-614

Abstract

Background: Anti-IL-5 antibodies represent an established therapy for severe eosinophilic asthma (SEA), but some patients show inadequate response. The objective of this study was to assess the effects of a switch to anti-IL-5R alpha therapy in patients with inadequate response to anti-IL-5 therapy. Methods: In this retrospective multi-centre, real-life study, we analysed all SEA patients switched from anti-IL-5 to anti-IL-5R alpha therapy due to inadequate response or intolerability. Pulmonary function tests, blood gas analyses, asthma control tests (ACT) and oral corticosteroid (OCS) usage were analysed and compared at three timepoints: baseline (BL, before anti-IL-5 therapy), timepoint 1 (T1, under anti-IL-5 therapy) and timepoint 2 (T2, under anti-IL-5R alpha therapy). Results: Of 665 patients treated with anti-IL-5 antibodies, 70 were switched to anti-IL-5R alpha and 60 were included in the analysis. Median treatment duration was 8 months [IQR 5;15] for anti-IL-5 and 5 months [IQR 4;6] for anti-IL-5R alpha therapy. FEV1 was 61% of predicted at BL [IQR 41;74], 61% [IQR 43;79] at T1 and 68% [IQR 49;87] at T2 (P-T1-(T2)=0.011). ACT score was 10 [IQR 8;13], 16 [IQR 10;19] and 19 [IQR 14;22], respectively (both p<0.001). The number of patients requiring OCS was reduced from 41 (BL) to 32 (T1) and 19 (T2) (both p<0.001). Ten patients discontinued anti-IL-5Ra therapy due to insufficient efficacy (n=7) and adverse events (n=3). Conclusion: Switching from anti-IL-5 to anti-IL-5R alpha therapy in patients with inadequate response was associated with significantly improved FEV1, asthma control and OCS reduction.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1178-6965
• Sprache: Englisch