A Multicenter Retrospective Study Evaluating IL-5-Targeted Biologic Therapies for the Treatment of Asthma and Allergic Bronchopulmonary Aspergillosis in Adults With Cystic FibrosisTake-Home Points
Background: Biologic therapies targeting T-helper cell type 2 (Th2) eosinophilic inflammation have been used for difficult-to-treat asthma and allergic bronchopulmonary aspergillosis (ABPA), but safety and efficacy data are limited in the cystic fibrosis (CF) population. Research Question: Are Th2 b...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-06-01
|
| Series: | CHEST Pulmonary |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2949789225000303 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849336615676149760 |
|---|---|
| author | Sameer Desai, PhD Sophia Shen, MD Zosia Gryz, BSc Elizabeth Tullis, MD Anne L. Stephenson, MD, PhD Bradley S. Quon, MD, MSc |
| author_facet | Sameer Desai, PhD Sophia Shen, MD Zosia Gryz, BSc Elizabeth Tullis, MD Anne L. Stephenson, MD, PhD Bradley S. Quon, MD, MSc |
| author_sort | Sameer Desai, PhD |
| collection | DOAJ |
| description | Background: Biologic therapies targeting T-helper cell type 2 (Th2) eosinophilic inflammation have been used for difficult-to-treat asthma and allergic bronchopulmonary aspergillosis (ABPA), but safety and efficacy data are limited in the cystic fibrosis (CF) population. Research Question: Are Th2 biologic therapies targeting eosinophilic inflammation effective and safe when used in adults with CF with asthma and/or ABPA overlap? Study Design and Methods: This was a retrospective multicenter study. Individuals with CF receiving Th2 biologic therapies for asthma or ABPA at 2 large adult CF centers between 2016 and 2021 were included. Treatment safety and effectiveness up to 12 months after biologic initiation were evaluated. Outcomes of interest included percent predicted FEV1 (ppFEV1), rate of change in ppFEV1, cumulative systemic corticosteroid (SCS) dose, and frequency of pulmonary exacerbations (PExs). Results: Forty adults with CF received Th2 biologic therapies targeting eosinophilic inflammation during the study period. A total of 38 were eligible for study inclusion, and all received IL-5-directed therapies (mepolizumab: n = 27, benralizumab: n = 11): 17 (45%) for asthma only and 21 for ABPA (55%) with or without asthma. No significant biologic-related adverse effects were observed. There was no statistical difference in ppFEV1 from baseline to 12-months postbiologic initiation, but the rate of change in ppFEV1 improved in the 12 months postbiologic vs prebiologic with a pre-to-post difference of 3.7% (95% CI, 1.2%-6.3%). SCS dose and frequency of PExs requiring hospitalization did not differ significantly in the 12 months before biologic vs after biologic initiation. Interpretation: Our results show that in adults with CF, anti-IL-5 biologic therapies were well tolerated and can improve rate of change in lung function, but there was no impact on SCS use or PEx frequency. Further study is needed to better define the role of Th2 biologics in the era of highly effective modulator therapy. |
| format | Article |
| id | doaj-art-0e9f6b722aa544bea993e9bed9828fa6 |
| institution | Kabale University |
| issn | 2949-7892 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | CHEST Pulmonary |
| spelling | doaj-art-0e9f6b722aa544bea993e9bed9828fa62025-08-20T03:44:55ZengElsevierCHEST Pulmonary2949-78922025-06-013210016310.1016/j.chpulm.2025.100163A Multicenter Retrospective Study Evaluating IL-5-Targeted Biologic Therapies for the Treatment of Asthma and Allergic Bronchopulmonary Aspergillosis in Adults With Cystic FibrosisTake-Home PointsSameer Desai, PhD0Sophia Shen, MD1Zosia Gryz, BSc2Elizabeth Tullis, MD3Anne L. Stephenson, MD, PhD4Bradley S. Quon, MD, MSc5School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada; Department of Biostatistics, Epidemiology, and Scientific Computing, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi ArabiaFaculty of Medicine, University of British Columbia, Vancouver, BC, CanadaDivision of Respirology, St Michael’s Hospital, University of Toronto, Toronto, ON, CanadaDivision of Respirology, St Michael’s Hospital, University of Toronto, Toronto, ON, CanadaDivision of Respirology, St Michael’s Hospital, University of Toronto, Toronto, ON, CanadaDivision of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada; Centre for Heart Lung Innovation, St Paul’s Hospital and the University of British Columbia, Vancouver, BC, Canada; CORRESPONDENCE TO: Bradley S. QuonBackground: Biologic therapies targeting T-helper cell type 2 (Th2) eosinophilic inflammation have been used for difficult-to-treat asthma and allergic bronchopulmonary aspergillosis (ABPA), but safety and efficacy data are limited in the cystic fibrosis (CF) population. Research Question: Are Th2 biologic therapies targeting eosinophilic inflammation effective and safe when used in adults with CF with asthma and/or ABPA overlap? Study Design and Methods: This was a retrospective multicenter study. Individuals with CF receiving Th2 biologic therapies for asthma or ABPA at 2 large adult CF centers between 2016 and 2021 were included. Treatment safety and effectiveness up to 12 months after biologic initiation were evaluated. Outcomes of interest included percent predicted FEV1 (ppFEV1), rate of change in ppFEV1, cumulative systemic corticosteroid (SCS) dose, and frequency of pulmonary exacerbations (PExs). Results: Forty adults with CF received Th2 biologic therapies targeting eosinophilic inflammation during the study period. A total of 38 were eligible for study inclusion, and all received IL-5-directed therapies (mepolizumab: n = 27, benralizumab: n = 11): 17 (45%) for asthma only and 21 for ABPA (55%) with or without asthma. No significant biologic-related adverse effects were observed. There was no statistical difference in ppFEV1 from baseline to 12-months postbiologic initiation, but the rate of change in ppFEV1 improved in the 12 months postbiologic vs prebiologic with a pre-to-post difference of 3.7% (95% CI, 1.2%-6.3%). SCS dose and frequency of PExs requiring hospitalization did not differ significantly in the 12 months before biologic vs after biologic initiation. Interpretation: Our results show that in adults with CF, anti-IL-5 biologic therapies were well tolerated and can improve rate of change in lung function, but there was no impact on SCS use or PEx frequency. Further study is needed to better define the role of Th2 biologics in the era of highly effective modulator therapy.http://www.sciencedirect.com/science/article/pii/S2949789225000303allergic bronchopulmonary aspergillosisasthmabenralizumabcystic fibrosismepolizumabABPA, Th2 |
| spellingShingle | Sameer Desai, PhD Sophia Shen, MD Zosia Gryz, BSc Elizabeth Tullis, MD Anne L. Stephenson, MD, PhD Bradley S. Quon, MD, MSc A Multicenter Retrospective Study Evaluating IL-5-Targeted Biologic Therapies for the Treatment of Asthma and Allergic Bronchopulmonary Aspergillosis in Adults With Cystic FibrosisTake-Home Points CHEST Pulmonary allergic bronchopulmonary aspergillosis asthma benralizumab cystic fibrosis mepolizumab ABPA, Th2 |
| title | A Multicenter Retrospective Study Evaluating IL-5-Targeted Biologic Therapies for the Treatment of Asthma and Allergic Bronchopulmonary Aspergillosis in Adults With Cystic FibrosisTake-Home Points |
| title_full | A Multicenter Retrospective Study Evaluating IL-5-Targeted Biologic Therapies for the Treatment of Asthma and Allergic Bronchopulmonary Aspergillosis in Adults With Cystic FibrosisTake-Home Points |
| title_fullStr | A Multicenter Retrospective Study Evaluating IL-5-Targeted Biologic Therapies for the Treatment of Asthma and Allergic Bronchopulmonary Aspergillosis in Adults With Cystic FibrosisTake-Home Points |
| title_full_unstemmed | A Multicenter Retrospective Study Evaluating IL-5-Targeted Biologic Therapies for the Treatment of Asthma and Allergic Bronchopulmonary Aspergillosis in Adults With Cystic FibrosisTake-Home Points |
| title_short | A Multicenter Retrospective Study Evaluating IL-5-Targeted Biologic Therapies for the Treatment of Asthma and Allergic Bronchopulmonary Aspergillosis in Adults With Cystic FibrosisTake-Home Points |
| title_sort | multicenter retrospective study evaluating il 5 targeted biologic therapies for the treatment of asthma and allergic bronchopulmonary aspergillosis in adults with cystic fibrosistake home points |
| topic | allergic bronchopulmonary aspergillosis asthma benralizumab cystic fibrosis mepolizumab ABPA, Th2 |
| url | http://www.sciencedirect.com/science/article/pii/S2949789225000303 |
| work_keys_str_mv | AT sameerdesaiphd amulticenterretrospectivestudyevaluatingil5targetedbiologictherapiesforthetreatmentofasthmaandallergicbronchopulmonaryaspergillosisinadultswithcysticfibrosistakehomepoints AT sophiashenmd amulticenterretrospectivestudyevaluatingil5targetedbiologictherapiesforthetreatmentofasthmaandallergicbronchopulmonaryaspergillosisinadultswithcysticfibrosistakehomepoints AT zosiagryzbsc amulticenterretrospectivestudyevaluatingil5targetedbiologictherapiesforthetreatmentofasthmaandallergicbronchopulmonaryaspergillosisinadultswithcysticfibrosistakehomepoints AT elizabethtullismd amulticenterretrospectivestudyevaluatingil5targetedbiologictherapiesforthetreatmentofasthmaandallergicbronchopulmonaryaspergillosisinadultswithcysticfibrosistakehomepoints AT annelstephensonmdphd amulticenterretrospectivestudyevaluatingil5targetedbiologictherapiesforthetreatmentofasthmaandallergicbronchopulmonaryaspergillosisinadultswithcysticfibrosistakehomepoints AT bradleysquonmdmsc amulticenterretrospectivestudyevaluatingil5targetedbiologictherapiesforthetreatmentofasthmaandallergicbronchopulmonaryaspergillosisinadultswithcysticfibrosistakehomepoints AT sameerdesaiphd multicenterretrospectivestudyevaluatingil5targetedbiologictherapiesforthetreatmentofasthmaandallergicbronchopulmonaryaspergillosisinadultswithcysticfibrosistakehomepoints AT sophiashenmd multicenterretrospectivestudyevaluatingil5targetedbiologictherapiesforthetreatmentofasthmaandallergicbronchopulmonaryaspergillosisinadultswithcysticfibrosistakehomepoints AT zosiagryzbsc multicenterretrospectivestudyevaluatingil5targetedbiologictherapiesforthetreatmentofasthmaandallergicbronchopulmonaryaspergillosisinadultswithcysticfibrosistakehomepoints AT elizabethtullismd multicenterretrospectivestudyevaluatingil5targetedbiologictherapiesforthetreatmentofasthmaandallergicbronchopulmonaryaspergillosisinadultswithcysticfibrosistakehomepoints AT annelstephensonmdphd multicenterretrospectivestudyevaluatingil5targetedbiologictherapiesforthetreatmentofasthmaandallergicbronchopulmonaryaspergillosisinadultswithcysticfibrosistakehomepoints AT bradleysquonmdmsc multicenterretrospectivestudyevaluatingil5targetedbiologictherapiesforthetreatmentofasthmaandallergicbronchopulmonaryaspergillosisinadultswithcysticfibrosistakehomepoints |