학술논문
Blood eosinophils and fractional exhaled nitric oxide are prognostic and predictive biomarkers in childhood asthma.
Document Type
Academic Journal
Author
Bacharier LB; Monroe Carell Jr Children's Hospital at Vanderbilt University Medical Center, Nashville, Tenn. Electronic address: leonard.bacharier@vumc.org.; Pavord ID; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom.; Maspero JF; Fundación CIDEA, Buenos Aires, Argentina.; Jackson DJ; University of Wisconsin School of Medicine and Public Health, Madison, Wis.; Fiocchi AG; Bambino Gesù Children's Hospital IRCCS, Rome, Italy.; Mao X; Sanofi, Bridgewater, NJ.; Jacob-Nara JA; Sanofi, Bridgewater, NJ.; Deniz Y; Regeneron Pharmaceuticals Inc, Tarrytown, NY.; Laws E; Sanofi, Bridgewater, NJ.; Mannent LP; Sanofi, Chilly-Mazarin, France.; Amin N; Sanofi, Bridgewater, NJ.; Akinlade B; Sanofi, Bridgewater, NJ.; Staudinger HW; Sanofi, Bridgewater, NJ.; Lederer DJ; Regeneron Pharmaceuticals Inc, Tarrytown, NY.; Hardin M; Sanofi, Cambridge, Mass.
Source
Publisher: Mosby Country of Publication: United States NLM ID: 1275002 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6825 (Electronic) Linking ISSN: 00916749 NLM ISO Abbreviation: J Allergy Clin Immunol Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Blood eosinophils and fractional exhaled nitric oxide (Feno) are prognostic biomarkers for exacerbations and predict lung function responses to dupilumab in adolescents and adults with asthma.
Objective: We evaluated the relationship between baseline blood eosinophils and Feno and response to dupilumab in children with asthma.
Methods: Children aged 6 to 11 years with uncontrolled moderate-to-severe asthma (n = 408) were randomized to receive dupilumab 100/200 mg by body weight or volume-matched placebo every 2 weeks for 52 weeks. Annualized exacerbation rate (AER) reduction and least squares mean change in prebronchodilator percent predicted forced expiratory volume in 1 second (ppFEV1 ) at week 12 were assessed according to cutoff baseline levels for Feno (<20 ppb vs ≥20 ppb) and blood eosinophil count (<150, ≥150 to <300, ≥300 to <500, and ≥500 cells/μL). Quadrant analyses in populations defined by biomarker thresholds and spline models across continuous end points assessed the relationship with Feno and eosinophil count. Interaction testing evaluated the independent roles of Feno and blood eosinophils as predictive markers.
Results: Exacerbation risk and magnitude of AER reduction increased in subgroups with higher baseline biomarker levels. Quadrant analyses revealed that disease of patients with either elevated Feno or eosinophil counts demonstrated a clinical response to dupilumab. Interaction testing indicated blood eosinophil counts or Feno independently added value as predictive biomarkers.
Conclusions: In children with uncontrolled moderate-to-severe asthma, blood eosinophil counts and Feno are clinically relevant biomarkers to identify those at risk for asthma exacerbations, as well as those with disease with clinical response to dupilumab.
Trial Registration: Liberty Asthma VOYAGE ClinicalTrials.gov NCT02948959.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Objective: We evaluated the relationship between baseline blood eosinophils and Feno and response to dupilumab in children with asthma.
Methods: Children aged 6 to 11 years with uncontrolled moderate-to-severe asthma (n = 408) were randomized to receive dupilumab 100/200 mg by body weight or volume-matched placebo every 2 weeks for 52 weeks. Annualized exacerbation rate (AER) reduction and least squares mean change in prebronchodilator percent predicted forced expiratory volume in 1 second (ppFEV
Results: Exacerbation risk and magnitude of AER reduction increased in subgroups with higher baseline biomarker levels. Quadrant analyses revealed that disease of patients with either elevated Feno or eosinophil counts demonstrated a clinical response to dupilumab. Interaction testing indicated blood eosinophil counts or Feno independently added value as predictive biomarkers.
Conclusions: In children with uncontrolled moderate-to-severe asthma, blood eosinophil counts and Feno are clinically relevant biomarkers to identify those at risk for asthma exacerbations, as well as those with disease with clinical response to dupilumab.
Trial Registration: Liberty Asthma VOYAGE ClinicalTrials.gov NCT02948959.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)