MedElevator
Войти в исследования The journal of allergy and clinical immunology. In practice · 2026
Influence of newly initiated biologic therapy on the dose of ICS therapy - Data from the German Asthma Net.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Stoshikj Slagjana, Renner Andreas, Bal Christina, Krall Christoph, Skowasch Dirk, Milger Katrin, Schulz Christian, Jandl Margret, Ehmann Rainer, Schmidt Olaf, Buhl Roland, Hamelmann Eckard, Taube Christian, Korn Stephanie, Idzko Marco, German Asthma Net (GAN) study group
Аннотация
BACKGROUND: Real-world data on inhaled corticosteroid (ICS) reduction after biologic initiation in severe asthma are limited.
OBJECTIVES: We assessed high dose (HD)-ICS reduction and its association with asthma control, exacerbations, lung function, and fractional exhaled nitric oxide (FeNO).
METHODS: Adults in the German Asthma Net registry initiating benralizumab, dupilumab, mepolizumab, omalizumab, reslizumab, or tezepelumab with documented ICS use and 4-month, 1-, or 2-year follow-up were analyzed. ICS doses were converted to beclomethasone dipropionate equivalents (BDE) per GINA and reducers were defined by HD-ICS step-down to medium/low-dose ICS during follow-up and compared to non-reducers. Remission was defined as an Asthma Control Test (ACT) ≥20, no exacerbations, and no oral corticosteroids after 1 year of biologics. Analyses used adjusted linear, log-linear, and Poisson regression models (standard or mixed-effects, as appropriate), along with Kendall's τ and Spearman's rank correlation coefficients.
RESULTS: Among 1,181 patients (1,372 visits; 55 ± 13 years; 57% female), HD-ICS use declined from 90.7% to 79.9% over 2 years. Median BDEs dose decreased from 1600 to 1000 μg (n=287; P=.004). ICS-Reduction was observed in patients with greater improvements in ACT, ACQ-5 and mAQLQ than in patients not reducing (all P<.05) without worsening exacerbations over 2 years. Reduction after 4 months was associated with better FEV1 improvement (all P=.03) but not thereafter; other lung function measures improved comparably, except for greater FRC reduction among reducers at year 2 (P=.02). FeNO decreased overall, with a smaller 1-year reduction among reducers (P = .050). Remission was associated with higher ICS reduction rates (year 1: 23.0% vs. 8.7 %, P=.0001; year 2: 26.3% vs. 10.8%, P=.004). Correlation analyses largely confirmed the main findings.
CONCLUSION: ICS reduction was associated with improved patient-reported outcomes without worsening exacerbations, lung function or FeNO.
OBJECTIVES: We assessed high dose (HD)-ICS reduction and its association with asthma control, exacerbations, lung function, and fractional exhaled nitric oxide (FeNO).
METHODS: Adults in the German Asthma Net registry initiating benralizumab, dupilumab, mepolizumab, omalizumab, reslizumab, or tezepelumab with documented ICS use and 4-month, 1-, or 2-year follow-up were analyzed. ICS doses were converted to beclomethasone dipropionate equivalents (BDE) per GINA and reducers were defined by HD-ICS step-down to medium/low-dose ICS during follow-up and compared to non-reducers. Remission was defined as an Asthma Control Test (ACT) ≥20, no exacerbations, and no oral corticosteroids after 1 year of biologics. Analyses used adjusted linear, log-linear, and Poisson regression models (standard or mixed-effects, as appropriate), along with Kendall's τ and Spearman's rank correlation coefficients.
RESULTS: Among 1,181 patients (1,372 visits; 55 ± 13 years; 57% female), HD-ICS use declined from 90.7% to 79.9% over 2 years. Median BDEs dose decreased from 1600 to 1000 μg (n=287; P=.004). ICS-Reduction was observed in patients with greater improvements in ACT, ACQ-5 and mAQLQ than in patients not reducing (all P<.05) without worsening exacerbations over 2 years. Reduction after 4 months was associated with better FEV1 improvement (all P=.03) but not thereafter; other lung function measures improved comparably, except for greater FRC reduction among reducers at year 2 (P=.02). FeNO decreased overall, with a smaller 1-year reduction among reducers (P = .050). Remission was associated with higher ICS reduction rates (year 1: 23.0% vs. 8.7 %, P=.0001; year 2: 26.3% vs. 10.8%, P=.004). Correlation analyses largely confirmed the main findings.
CONCLUSION: ICS reduction was associated with improved patient-reported outcomes without worsening exacerbations, lung function or FeNO.