PURPOSE: To characterize the clinical phenotypes of severe eosinophilic asthma based on early responsiveness to benralizumab in terms of forced expiratory volume in 1 second (FEV1) improvement. PATIENTS AND METHODS: Sixty-four participants diagnosed with severe eosinophilic asthma and who had completed 4 months of benralizumab treatment were included in this analysis. Pre-treatment clinical factors were compared between responders and non-responders according to improvements in ACT or FEV1. Correlations between the sums of increased Type 2-related inflammatory parameters and changes of ACT or FEV1 were also evaluated before and after the 4-month treatment. A two-step cluster analysis was performed to identify distinct phenotypes related to benralizumab responsiveness in terms of FEV1. RESULTS: At the 4-month timepoint, all parameters, except for FeNO, were significantly improved after benralizumab treatment. FEV1 responders were associated with higher levels of Type 2-related inflammatory parameters. An improvement in FEV1 but not in ACT was clearly associated with increases in the sums of increased type 2-related inflammation parameters (p = 0.0001). The cluster analysis identified 5 distinct phenotypes of severe eosinophilic asthma according to the variable FEV1 responsiveness to benralizumab. The greatest response was found in the distinct phenotype of severe eosinophilic asthma, which was characterized by modest increase in total IgE and FeNO relative to blood eosinophils with least exposure to smoking. CONCLUSION: This study, to the best of our knowledge, is the first cluster analysis to report distinct phenotypes related to clinical benralizumab response in a real-world population with severe eosinophilic asthma. These results may help to predict responsiveness to benralizumab in patients with severe eosinophilic asthma.
PURPOSE: To characterize the clinical phenotypes of severe eosinophilic asthma based on early responsiveness to benralizumab in terms of forced expiratory volume in 1 second (FEV1) improvement. PATIENTS AND METHODS: Sixty-four participants diagnosed with severe eosinophilic asthma and who had completed 4 months of benralizumab treatment were included in this analysis. Pre-treatment clinical factors were compared between responders and non-responders according to improvements in ACT or FEV1. Correlations between the sums of increased Type 2-related inflammatory parameters and changes of ACT or FEV1 were also evaluated before and after the 4-month treatment. A two-step cluster analysis was performed to identify distinct phenotypes related to benralizumab responsiveness in terms of FEV1. RESULTS: At the 4-month timepoint, all parameters, except for FeNO, were significantly improved after benralizumab treatment. FEV1 responders were associated with higher levels of Type 2-related inflammatory parameters. An improvement in FEV1 but not in ACT was clearly associated with increases in the sums of increased type 2-related inflammation parameters (p = 0.0001). The cluster analysis identified 5 distinct phenotypes of severe eosinophilic asthma according to the variable FEV1 responsiveness to benralizumab. The greatest response was found in the distinct phenotype of severe eosinophilic asthma, which was characterized by modest increase in total IgE and FeNO relative to blood eosinophils with least exposure to smoking. CONCLUSION: This study, to the best of our knowledge, is the first cluster analysis to report distinct phenotypes related to clinical benralizumab response in a real-world population with severe eosinophilic asthma. These results may help to predict responsiveness to benralizumab in patients with severe eosinophilic asthma.
Authors: Eugene R Bleecker; J Mark FitzGerald; Pascal Chanez; Alberto Papi; Steven F Weinstein; Peter Barker; Stephanie Sproule; Geoffrey Gilmartin; Magnus Aurivillius; Viktoria Werkström; Mitchell Goldman Journal: Lancet Date: 2016-09-05 Impact factor: 79.321
Authors: J Mark FitzGerald; Eugene R Bleecker; Parameswaran Nair; Stephanie Korn; Ken Ohta; Marek Lommatzsch; Gary T Ferguson; William W Busse; Peter Barker; Stephanie Sproule; Geoffrey Gilmartin; Viktoria Werkström; Magnus Aurivillius; Mitchell Goldman Journal: Lancet Date: 2016-09-05 Impact factor: 79.321
Authors: Joanne E Kavanagh; Andrew P Hearn; Jaideep Dhariwal; Gráinne d'Ancona; Abdel Douiri; Cris Roxas; Mariana Fernandes; Linda Green; Louise Thomson; Alexandra M Nanzer; Brian D Kent; David J Jackson Journal: Chest Date: 2020-08-31 Impact factor: 9.410
Authors: Parameswaran Nair; Sally Wenzel; Klaus F Rabe; Arnaud Bourdin; Njira L Lugogo; Piotr Kuna; Peter Barker; Stephanie Sproule; Sandhia Ponnarambil; Mitchell Goldman Journal: N Engl J Med Date: 2017-05-22 Impact factor: 91.245
Authors: Eugene R Bleecker; Michael E Wechsler; J Mark FitzGerald; Andrew Menzies-Gow; Yanping Wu; Ian Hirsch; Mitchell Goldman; Paul Newbold; James G Zangrilli Journal: Eur Respir J Date: 2018-10-18 Impact factor: 16.671
Authors: Angela M Moran; Sanjay Ramakrishnan; Catherine A Borg; Clare M Connolly; Simon Couillard; Christine M Mwasuku; Ian D Pavord; Timothy S C Hinks; Lauri Lehtimӓki Journal: Am J Respir Crit Care Med Date: 2020-11-01 Impact factor: 21.405
Authors: Ismael García-Moguel; Ana Rosado; Aída Gómez-Cardeñosa; Mar Gandolfo-Cano; Teresa Robledo Echarren; Maria Del Mar Moro Moro; Mª Del Mar Reaño Martos; Rafael Pineda-Pineda; Marcela Valverde-Monge; Cristina Martin-Arriscado Arroba; Javier Domínguez-Ortega Journal: J Asthma Allergy Date: 2022-05-13