Section of Allergy, Asthma, and Immunology, Department of Medicine, Penn State College of Medicine, Hershey, Pa.
Section of Allergy, Asthma, and Immunology, Department of Medicine, Penn State College of Medicine, Hershey, Pa.
J Allergy Clin Immunol Pract. 2024 Jun;12(6):1558-1567. doi: 10.1016/j.jaip.2024.02.029. Epub 2024 Feb 27.
Biologic modifiers targeting type 2 (T2) airway inflammation are effective in reducing asthma exacerbation. However, real-world and comparative effectiveness studies remain limited.
To examine and compare the real-world impact of anti-T2 asthma biologics.
In this retrospective, new user cohort study, we used the MarketScan, a Commercial Claims and Encounters Database, to identify adult patients with asthma who began to receive an anti-T2 biologic agent (anti-IL-5s, dupilumab, or omalizumab). We examined the influence of the biologic class on asthma exacerbation by comparing the average number of asthma exacerbation 1 year before and after biologic initiation. We conducted multivariable regression analyses to compare the effectiveness of these asthma biologics on reducing the incidence of asthma exacerbations within 18 months of the initial administration of biologics while controlling for demographic variables, comorbidities, and asthma severity.
We identified 5,538 asthma patients who were new to taking an anti-T2 biologic [mean age [±SD], 45.6 (12.78) years; 65.8% female). Asthma biologics reduced asthma exacerbation by 11% to 47%, particularly among patients with two or more asthma exacerbations in the year preceding biologic initiation (31% to 65% reduction). Biologics were especially effective in reducing asthma-related hospitalizations (44.6% to 60%). After adjusting for baseline demographics, asthma medication, and comorbidities, dupilumab was associated with a lower estimated mean number of asthma exacerbation per year and lower adjusted odds ratio for developing an asthma exacerbation relative to other biologics (50% to 80% less likely).
Anti-T2 asthma biologics reduced asthma exacerbation in real-word settings. Evidence supports growing literature reporting that dupilumab might have a more favorable impact on asthma exacerbation relative to other asthma biologics.
针对 2 型（T2）气道炎症的生物调节剂可有效减少哮喘恶化。然而，真实世界和比较有效性研究仍然有限。
研究和比较抗 T2 哮喘生物制剂的真实世界影响。
在这项回顾性、新用户队列研究中，我们使用 MarketScan，这是一个商业索赔和遭遇数据库，来识别开始接受抗 T2 生物制剂（抗 IL-5s、度普利尤单抗或奥马珠单抗）的成年哮喘患者。我们通过比较生物制剂起始前 1 年和起始后 1 年哮喘恶化的平均次数，来研究生物制剂类别对哮喘恶化的影响。我们进行了多变量回归分析，以比较这些哮喘生物制剂在控制人口统计学变量、合并症和哮喘严重程度的情况下，在初始使用生物制剂后 18 个月内降低哮喘恶化发生率的效果。
我们确定了 5538 名新开始接受抗 T2 生物制剂的哮喘患者[平均年龄（±标准差），45.6（12.78）岁；65.8%为女性]。哮喘生物制剂可将哮喘恶化减少 11%至 47%，尤其是在生物制剂起始前一年有两次或更多次哮喘恶化的患者中（减少 31%至 65%）。生物制剂尤其能有效减少与哮喘相关的住院治疗（减少 44.6%至 60%）。在调整基线人口统计学、哮喘药物和合并症后，与其他生物制剂相比，度普利尤单抗与每年哮喘恶化的估计平均次数较低以及发生哮喘恶化的调整后比值比较低相关（减少 50%至 80%）。
抗 T2 哮喘生物制剂可减少真实环境中的哮喘恶化。有证据支持越来越多的文献报道，与其他哮喘生物制剂相比，度普利尤单抗可能对哮喘恶化有更有利的影响。
