Respiratory investigation · 2025
Clinical and complete remission in patients with severe asthma with 24-month dupilumab treatment.
СтатьяНазвание и аннотация: Перевод в очереди
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Tajiri Tomoko, Suzuki Motohiko, Nishiyama Hirono, Suzuki Tatsuro, Amakusa Yuki, Ito Keima, Mori Yuta, Fukumitsu Kensuke, Fukuda Satoshi, Kanemitsu Yoshihiro, Uemura Takehiro, Ohkubo Hirotsugu, Takemura Masaya, Ito Yutaka, Oguri Tetsuya, Niimi Akio
Аннотация
BACKGROUND: A few studies have reported asthma clinical remission with 24-month dupilumab therapy; however, complete remission remains unknown. In this post hoc analysis of our previous study, the achievement rates of clinical and complete remissions, and the factors associated with clinical remission with 24-month dupilumab therapy were assessed in adult patients with severe asthma.
METHODS: Twenty-eight patients who had participated in our previous study were included. The primary outcome was the achievement rates of three-component clinical remission, four-component clinical remission, and complete remission at 24 months. The secondary outcome was the factors associated with achievement of four-component clinical remission at 24 months. Three-component or four-component clinical remission was defined as: 1) no significant asthma symptoms; 2) oral corticosteroid-free; 3) exacerbation-free; with or without 4) normalized pulmonary function. Complete remission was defined as four-component clinical remission plus 5) the resolution of asthma-related inflammation and 6) negative airway hyperresponsiveness.
RESULTS: At 24 months, 19 (68 %), 16 (57 %), and 2 patients (7 %) achieved three-component, four-component clinical remission, and complete remission, respectively. At 24 months, patients with a higher incidence of comorbid chronic rhinosinusitis with nasal polyps, lower incidence of comorbid depression/anxiety, higher type 2 biomarkers, lower inhaled corticosteroid dose, better asthma control at baseline, and fewer exacerbations, unscheduled physicians' visit or hospitalization in the previous year more frequently achieved four-component clinical remission than those without (all P < 0.05).
CONCLUSIONS: The achievement rates of clinical or complete remission were maintained for up to 24 months in patients with severe asthma receiving dupilumab therapy.
TRIAL REGISTRATION: This study was registered in the UMIN Clinical Trial Registry (UMIN000038669).
METHODS: Twenty-eight patients who had participated in our previous study were included. The primary outcome was the achievement rates of three-component clinical remission, four-component clinical remission, and complete remission at 24 months. The secondary outcome was the factors associated with achievement of four-component clinical remission at 24 months. Three-component or four-component clinical remission was defined as: 1) no significant asthma symptoms; 2) oral corticosteroid-free; 3) exacerbation-free; with or without 4) normalized pulmonary function. Complete remission was defined as four-component clinical remission plus 5) the resolution of asthma-related inflammation and 6) negative airway hyperresponsiveness.
RESULTS: At 24 months, 19 (68 %), 16 (57 %), and 2 patients (7 %) achieved three-component, four-component clinical remission, and complete remission, respectively. At 24 months, patients with a higher incidence of comorbid chronic rhinosinusitis with nasal polyps, lower incidence of comorbid depression/anxiety, higher type 2 biomarkers, lower inhaled corticosteroid dose, better asthma control at baseline, and fewer exacerbations, unscheduled physicians' visit or hospitalization in the previous year more frequently achieved four-component clinical remission than those without (all P < 0.05).
CONCLUSIONS: The achievement rates of clinical or complete remission were maintained for up to 24 months in patients with severe asthma receiving dupilumab therapy.
TRIAL REGISTRATION: This study was registered in the UMIN Clinical Trial Registry (UMIN000038669).