Comparative effectiveness of anti-IL5 and anti-IgE biologic classes in patients with severe asthma eligible for both

Paul E. Pfeffer; Nasloon Ali; Ruth Murray; Charlotte Ulrik; Trung N. Tran; Jorge Maspero; Matthew Peters; George C. Christoff; Mohsen Sadatsafavi; Carlos A. Torres-Duque; Alan Altraja; Lauri Lehtimäki; Nikolaos G Papadopoulos; Sundeep Salvi; Richard W. Costello; Breda Cushen; Enrico Heffler; Takashi Iwanaga; Mona Al-Ahmad; Désirée Larenas-Linnemann; Piotr Kuna; João A. Fonseca; Riyad Al-Lehebi; Chin Kook Rhee; Luis Perez-de-Llano; Diahn Warng Perng Steve; Bassam Mahboub; Eileen Wang; Celine Goh; Juntao Lyu; Anthony Newell; Marianna Alacqua; Andrey S. Belevskiy; Mohit Bhutani; Leif Bjermer; Unnur Bjornsdottir; Arnaud Bourdin; Anna von Bulow; John Busby; Giorgio Walter Canonica; Borja G. Cosio; Delbert R. Dorscheid; Mariana Muñoz-Esquerre; J. Mark FitzGerald; Esther Garcia Gil; Peter G. Gibson; Liam G. Heaney; Mark Hew; Ole Hilberg; Flavia Hoyte; David J. Jackson; Mariko Siyue Koh; Hsin Kuo Bruce Ko; Jae Ha Lee; Sverre Lehmann; Cláudia Chaves Loureiro; Dóra Lúðvíksdóttir; Andrew N. Menzies-Gow; Patrick Mitchell; Andriana I. Papaioannou; Todor A. Popov; Celeste M. Porsbjerg; Laila Salameh; Concetta Sirena; Camille Taillé; Christian Taube; Yuji Tohda; Michael E. Wechsler; David B. Price

doi:10.1111/all.15711

Comparative effectiveness of anti-IL5 and anti-IgE biologic classes in patients with severe asthma eligible for both

Paul E. Pfeffer, Nasloon Ali, Ruth Murray, Charlotte Ulrik, Trung N. Tran, Jorge Maspero, Matthew Peters, George C. Christoff, Mohsen Sadatsafavi, Carlos A. Torres-Duque, Alan Altraja, Lauri Lehtimäki, Nikolaos G Papadopoulos, Sundeep Salvi, Richard W. Costello, Breda Cushen, Enrico Heffler, Takashi Iwanaga, Mona Al-Ahmad, Désirée Larenas-LinnemannPiotr Kuna, João A. Fonseca, Riyad Al-Lehebi, Chin Kook Rhee, Luis Perez-de-Llano, Diahn Warng Perng Steve, Bassam Mahboub, Eileen Wang, Celine Goh, Juntao Lyu, Anthony Newell, Marianna Alacqua, Andrey S. Belevskiy, Mohit Bhutani, Leif Bjermer, Unnur Bjornsdottir, Arnaud Bourdin, Anna von Bulow, John Busby, Giorgio Walter Canonica, Borja G. Cosio, Delbert R. Dorscheid, Mariana Muñoz-Esquerre, J. Mark FitzGerald, Esther Garcia Gil, Peter G. Gibson, Liam G. Heaney, Mark Hew, Ole Hilberg, Flavia Hoyte, David J. Jackson, Mariko Siyue Koh, Hsin Kuo Bruce Ko, Jae Ha Lee, Sverre Lehmann, Cláudia Chaves Loureiro, Dóra Lúðvíksdóttir, Andrew N. Menzies-Gow, Patrick Mitchell, Andriana I. Papaioannou, Todor A. Popov, Celeste M. Porsbjerg, Laila Salameh, Concetta Sirena, Camille Taillé, Christian Taube, Yuji Tohda, Michael E. Wechsler, David B. Price

Division of Pulmonology

Research output: Contribution to journal › Article › peer-review

10 Scopus citations

Abstract

Background: Patients with severe asthma may present with characteristics representing overlapping phenotypes, making them eligible for more than one class of biologic. Our aim was to describe the profile of adult patients with severe asthma eligible for both anti-IgE and anti-IL5/5R and to compare the effectiveness of both classes of treatment in real life. Methods: This was a prospective cohort study that included adult patients with severe asthma from 22 countries enrolled into the International Severe Asthma registry (ISAR) who were eligible for both anti-IgE and anti-IL5/5R. The effectiveness of anti-IgE and anti-IL5/5R was compared in a 1:1 matched cohort. Exacerbation rate was the primary effectiveness endpoint. Secondary endpoints included long-term-oral corticosteroid (LTOCS) use, asthma-related emergency room (ER) attendance, and hospital admissions. Results: In the matched analysis (n = 350/group), the mean annualized exacerbation rate decreased by 47.1% in the anti-IL5/5R group and 38.7% in the anti-IgE group. Patients treated with anti-IL5/5R were less likely to experience a future exacerbation (adjusted IRR 0.76; 95% CI 0.64, 0.89; p < 0.001) and experienced a greater reduction in mean LTOCS dose than those treated with anti-IgE (37.44% vs. 20.55% reduction; p = 0.023). There was some evidence to suggest that patients treated with anti-IL5/5R experienced fewer asthma-related hospitalizations (IRR 0.64; 95% CI 0.38, 1.08), but not ER visits (IRR 0.94, 95% CI 0.61, 1.43). Conclusions: In real life, both anti-IgE and anti-IL5/5R improve asthma outcomes in patients eligible for both biologic classes; however, anti-IL5/5R was superior in terms of reducing asthma exacerbations and LTOCS use.

Original language	English
Pages (from-to)	1934-1948
Number of pages	15
Journal	Allergy: European Journal of Allergy and Clinical Immunology
Volume	78
Issue number	7
DOIs	https://doi.org/10.1111/all.15711
State	Published - Jul 2023

Bibliographical note

Publisher Copyright:
© 2023 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.

Keywords

ISAR
biologics
exacerbation
oral corticosteroids
real life

Access to Document

10.1111/all.15711

Cite this

Pfeffer, P. E., Ali, N., Murray, R., Ulrik, C., Tran, T. N., Maspero, J., Peters, M., Christoff, G. C., Sadatsafavi, M., Torres-Duque, C. A., Altraja, A., Lehtimäki, L., Papadopoulos, NG., Salvi, S., Costello, R. W., Cushen, B., Heffler, E., Iwanaga, T., Al-Ahmad, M., ... Price, D. B. (2023). Comparative effectiveness of anti-IL5 and anti-IgE biologic classes in patients with severe asthma eligible for both. Allergy: European Journal of Allergy and Clinical Immunology, 78(7), 1934-1948. https://doi.org/10.1111/all.15711

@article{b773d048f3284be8a4fd49ed7d931f10,

title = "Comparative effectiveness of anti-IL5 and anti-IgE biologic classes in patients with severe asthma eligible for both",

abstract = "Background: Patients with severe asthma may present with characteristics representing overlapping phenotypes, making them eligible for more than one class of biologic. Our aim was to describe the profile of adult patients with severe asthma eligible for both anti-IgE and anti-IL5/5R and to compare the effectiveness of both classes of treatment in real life. Methods: This was a prospective cohort study that included adult patients with severe asthma from 22 countries enrolled into the International Severe Asthma registry (ISAR) who were eligible for both anti-IgE and anti-IL5/5R. The effectiveness of anti-IgE and anti-IL5/5R was compared in a 1:1 matched cohort. Exacerbation rate was the primary effectiveness endpoint. Secondary endpoints included long-term-oral corticosteroid (LTOCS) use, asthma-related emergency room (ER) attendance, and hospital admissions. Results: In the matched analysis (n = 350/group), the mean annualized exacerbation rate decreased by 47.1% in the anti-IL5/5R group and 38.7% in the anti-IgE group. Patients treated with anti-IL5/5R were less likely to experience a future exacerbation (adjusted IRR 0.76; 95% CI 0.64, 0.89; p < 0.001) and experienced a greater reduction in mean LTOCS dose than those treated with anti-IgE (37.44% vs. 20.55% reduction; p = 0.023). There was some evidence to suggest that patients treated with anti-IL5/5R experienced fewer asthma-related hospitalizations (IRR 0.64; 95% CI 0.38, 1.08), but not ER visits (IRR 0.94, 95% CI 0.61, 1.43). Conclusions: In real life, both anti-IgE and anti-IL5/5R improve asthma outcomes in patients eligible for both biologic classes; however, anti-IL5/5R was superior in terms of reducing asthma exacerbations and LTOCS use.",

keywords = "ISAR, biologics, exacerbation, oral corticosteroids, real life",

author = "Pfeffer, {Paul E.} and Nasloon Ali and Ruth Murray and Charlotte Ulrik and Tran, {Trung N.} and Jorge Maspero and Matthew Peters and Christoff, {George C.} and Mohsen Sadatsafavi and Torres-Duque, {Carlos A.} and Alan Altraja and Lauri Lehtim{\"a}ki and Nikolaos G Papadopoulos and Sundeep Salvi and Costello, {Richard W.} and Breda Cushen and Enrico Heffler and Takashi Iwanaga and Mona Al-Ahmad and D{\'e}sir{\'e}e Larenas-Linnemann and Piotr Kuna and Fonseca, {Jo{\~a}o A.} and Riyad Al-Lehebi and Rhee, {Chin Kook} and Luis Perez-de-Llano and Perng Steve, {Diahn Warng} and Bassam Mahboub and Eileen Wang and Celine Goh and Juntao Lyu and Anthony Newell and Marianna Alacqua and Belevskiy, {Andrey S.} and Mohit Bhutani and Leif Bjermer and Unnur Bjornsdottir and Arnaud Bourdin and Bulow, {Anna von} and John Busby and Canonica, {Giorgio Walter} and Cosio, {Borja G.} and Dorscheid, {Delbert R.} and Mariana Mu{\~n}oz-Esquerre and FitzGerald, {J. Mark} and Gil, {Esther Garcia} and Gibson, {Peter G.} and Heaney, {Liam G.} and Mark Hew and Ole Hilberg and Flavia Hoyte and Jackson, {David J.} and Koh, {Mariko Siyue} and Ko, {Hsin Kuo Bruce} and Lee, {Jae Ha} and Sverre Lehmann and Cl{\'a}udia Chaves Loureiro and D{\'o}ra L{\'u}{\dh}v{\'i}ksd{\'o}ttir and Menzies-Gow, {Andrew N.} and Patrick Mitchell and Papaioannou, {Andriana I.} and Popov, {Todor A.} and Porsbjerg, {Celeste M.} and Laila Salameh and Concetta Sirena and Camille Taill{\'e} and Christian Taube and Yuji Tohda and Wechsler, {Michael E.} and Price, {David B.}",

note = "Publisher Copyright: {\textcopyright} 2023 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.",

year = "2023",

month = jul,

doi = "10.1111/all.15711",

language = "English",

volume = "78",

pages = "1934--1948",

journal = "Allergy: European Journal of Allergy and Clinical Immunology",

issn = "0105-4538",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "7",

}

Pfeffer, PE, Ali, N, Murray, R, Ulrik, C, Tran, TN, Maspero, J, Peters, M, Christoff, GC, Sadatsafavi, M, Torres-Duque, CA, Altraja, A, Lehtimäki, L, Papadopoulos, NG, Salvi, S, Costello, RW, Cushen, B, Heffler, E, Iwanaga, T, Al-Ahmad, M, Larenas-Linnemann, D, Kuna, P, Fonseca, JA, Al-Lehebi, R, Rhee, CK, Perez-de-Llano, L, Perng Steve, DW, Mahboub, B, Wang, E, Goh, C, Lyu, J, Newell, A, Alacqua, M, Belevskiy, AS, Bhutani, M, Bjermer, L, Bjornsdottir, U, Bourdin, A, Bulow, AV, Busby, J, Canonica, GW, Cosio, BG, Dorscheid, DR, Muñoz-Esquerre, M, FitzGerald, JM, Gil, EG, Gibson, PG, Heaney, LG, Hew, M, Hilberg, O, Hoyte, F, Jackson, DJ, Koh, MS, Ko, HKB, Lee, JH, Lehmann, S, Chaves Loureiro, C, Lúðvíksdóttir, D, Menzies-Gow, AN, Mitchell, P, Papaioannou, AI, Popov, TA, Porsbjerg, CM, Salameh, L, Sirena, C, Taillé, C, Taube, C, Tohda, Y, Wechsler, ME & Price, DB 2023, 'Comparative effectiveness of anti-IL5 and anti-IgE biologic classes in patients with severe asthma eligible for both', Allergy: European Journal of Allergy and Clinical Immunology, vol. 78, no. 7, pp. 1934-1948. https://doi.org/10.1111/all.15711

TY - JOUR

T1 - Comparative effectiveness of anti-IL5 and anti-IgE biologic classes in patients with severe asthma eligible for both

AU - Pfeffer, Paul E.

AU - Ali, Nasloon

AU - Murray, Ruth

AU - Ulrik, Charlotte

AU - Tran, Trung N.

AU - Maspero, Jorge

AU - Peters, Matthew

AU - Christoff, George C.

AU - Sadatsafavi, Mohsen

AU - Torres-Duque, Carlos A.

AU - Altraja, Alan

AU - Lehtimäki, Lauri

AU - Papadopoulos, Nikolaos G

AU - Salvi, Sundeep

AU - Costello, Richard W.

AU - Cushen, Breda

AU - Heffler, Enrico

AU - Iwanaga, Takashi

AU - Al-Ahmad, Mona

AU - Larenas-Linnemann, Désirée

AU - Kuna, Piotr

AU - Fonseca, João A.

AU - Al-Lehebi, Riyad

AU - Rhee, Chin Kook

AU - Perez-de-Llano, Luis

AU - Perng Steve, Diahn Warng

AU - Mahboub, Bassam

AU - Wang, Eileen

AU - Goh, Celine

AU - Lyu, Juntao

AU - Newell, Anthony

AU - Alacqua, Marianna

AU - Belevskiy, Andrey S.

AU - Bhutani, Mohit

AU - Bjermer, Leif

AU - Bjornsdottir, Unnur

AU - Bourdin, Arnaud

AU - Bulow, Anna von

AU - Busby, John

AU - Canonica, Giorgio Walter

AU - Cosio, Borja G.

AU - Dorscheid, Delbert R.

AU - Muñoz-Esquerre, Mariana

AU - FitzGerald, J. Mark

AU - Gil, Esther Garcia

AU - Gibson, Peter G.

AU - Heaney, Liam G.

AU - Hew, Mark

AU - Hilberg, Ole

AU - Hoyte, Flavia

AU - Jackson, David J.

AU - Koh, Mariko Siyue

AU - Ko, Hsin Kuo Bruce

AU - Lee, Jae Ha

AU - Lehmann, Sverre

AU - Chaves Loureiro, Cláudia

AU - Lúðvíksdóttir, Dóra

AU - Menzies-Gow, Andrew N.

AU - Mitchell, Patrick

AU - Papaioannou, Andriana I.

AU - Popov, Todor A.

AU - Porsbjerg, Celeste M.

AU - Salameh, Laila

AU - Sirena, Concetta

AU - Taillé, Camille

AU - Taube, Christian

AU - Tohda, Yuji

AU - Wechsler, Michael E.

AU - Price, David B.

PY - 2023/7

Y1 - 2023/7

N2 - Background: Patients with severe asthma may present with characteristics representing overlapping phenotypes, making them eligible for more than one class of biologic. Our aim was to describe the profile of adult patients with severe asthma eligible for both anti-IgE and anti-IL5/5R and to compare the effectiveness of both classes of treatment in real life. Methods: This was a prospective cohort study that included adult patients with severe asthma from 22 countries enrolled into the International Severe Asthma registry (ISAR) who were eligible for both anti-IgE and anti-IL5/5R. The effectiveness of anti-IgE and anti-IL5/5R was compared in a 1:1 matched cohort. Exacerbation rate was the primary effectiveness endpoint. Secondary endpoints included long-term-oral corticosteroid (LTOCS) use, asthma-related emergency room (ER) attendance, and hospital admissions. Results: In the matched analysis (n = 350/group), the mean annualized exacerbation rate decreased by 47.1% in the anti-IL5/5R group and 38.7% in the anti-IgE group. Patients treated with anti-IL5/5R were less likely to experience a future exacerbation (adjusted IRR 0.76; 95% CI 0.64, 0.89; p < 0.001) and experienced a greater reduction in mean LTOCS dose than those treated with anti-IgE (37.44% vs. 20.55% reduction; p = 0.023). There was some evidence to suggest that patients treated with anti-IL5/5R experienced fewer asthma-related hospitalizations (IRR 0.64; 95% CI 0.38, 1.08), but not ER visits (IRR 0.94, 95% CI 0.61, 1.43). Conclusions: In real life, both anti-IgE and anti-IL5/5R improve asthma outcomes in patients eligible for both biologic classes; however, anti-IL5/5R was superior in terms of reducing asthma exacerbations and LTOCS use.

AB - Background: Patients with severe asthma may present with characteristics representing overlapping phenotypes, making them eligible for more than one class of biologic. Our aim was to describe the profile of adult patients with severe asthma eligible for both anti-IgE and anti-IL5/5R and to compare the effectiveness of both classes of treatment in real life. Methods: This was a prospective cohort study that included adult patients with severe asthma from 22 countries enrolled into the International Severe Asthma registry (ISAR) who were eligible for both anti-IgE and anti-IL5/5R. The effectiveness of anti-IgE and anti-IL5/5R was compared in a 1:1 matched cohort. Exacerbation rate was the primary effectiveness endpoint. Secondary endpoints included long-term-oral corticosteroid (LTOCS) use, asthma-related emergency room (ER) attendance, and hospital admissions. Results: In the matched analysis (n = 350/group), the mean annualized exacerbation rate decreased by 47.1% in the anti-IL5/5R group and 38.7% in the anti-IgE group. Patients treated with anti-IL5/5R were less likely to experience a future exacerbation (adjusted IRR 0.76; 95% CI 0.64, 0.89; p < 0.001) and experienced a greater reduction in mean LTOCS dose than those treated with anti-IgE (37.44% vs. 20.55% reduction; p = 0.023). There was some evidence to suggest that patients treated with anti-IL5/5R experienced fewer asthma-related hospitalizations (IRR 0.64; 95% CI 0.38, 1.08), but not ER visits (IRR 0.94, 95% CI 0.61, 1.43). Conclusions: In real life, both anti-IgE and anti-IL5/5R improve asthma outcomes in patients eligible for both biologic classes; however, anti-IL5/5R was superior in terms of reducing asthma exacerbations and LTOCS use.

KW - ISAR

KW - biologics

KW - exacerbation

KW - oral corticosteroids

KW - real life

UR - http://www.scopus.com/inward/record.url?scp=85151412409&partnerID=8YFLogxK

U2 - 10.1111/all.15711

DO - 10.1111/all.15711

M3 - Article

C2 - 36929509

AN - SCOPUS:85151412409

SN - 0105-4538

VL - 78

SP - 1934

EP - 1948

JO - Allergy: European Journal of Allergy and Clinical Immunology

JF - Allergy: European Journal of Allergy and Clinical Immunology

IS - 7

ER -

Comparative effectiveness of anti-IL5 and anti-IgE biologic classes in patients with severe asthma eligible for both

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Keywords

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