Anti-interleukin 5 therapies failure criteria in severe asthma: a Delphi-consensus study

被引：3

作者：

Mattei, Laura ^{[1
]}

Suehs, Carey M. ^{[2
,3
]}

Alagha, Khuder ^{[2
,4
]}

Bourdin, Arnaud ^{[2
,5
,6
]}

Brousse, Christophe ^{[2
,4
]}

Charriot, Jeremy ^{[2
,5
]}

Devouassoux, Gilles ^{[6
,7
,8
]}

Fry, Stephanie ^{[6
,9
]}

Guilleminault, Laurent ^{[6
,10
,11
]}

Gouitaa, Marion ^{[1
]}

Taille, Camille ^{[6
,12
]}

Chanez, Pascal ^{[1
,6
,13
]}

Pahus, Laurie ^{[1
,6
,13
,14
]}

机构：

[1] Aix Marseille Univ, Clin Bronches Lallergie & Sommeil, APHM, Chemin Bourrely, F-13015 Marseille, France

[2] Univ Montpellier, CHU Montpellier, Dept Resp Dis, Montpellier, France

[3] Univ Montpellier, CHU Montpellier, Dept Med Informat, Montpellier, France

[4] Clin Parc, Castelnau Le Lez, France

[5] Univ Montpellier, CHU Montpellier, CNRS, INSERM,PhyMedExp, Montpellier, France

[6] Clin Res Initiat Severe Asthma Lever Innovat & Sc, FCRIN Network, INSERM, US 015, Toulouse, France

[7] Hosp Civils Lyon, Serv Pneumol, Hop Croix Rousse, Lyon, France

[8] Lyon 1 Claude Bernard Univ, South Med Univ Hosp, Inflammat & Immun Resp Epithelium, EA7426 PI3, Pierre Benite, France

[9] Univ Lille, Inst Pasteur Lille, Serv Pneumol & Immunoallergol, CHU Lille, Lille, France

[10] Toulouse Univ Hosp Ctr, Dept Resp Med, Toulouse, France

[11] Univ Toulouse, Toulouse Inst Infect & Inflammatory Dis Infinity, Inserm U1291, CNRS,U5282, Toulouse, France

[12] Univ Paris, Grp Hosp Univ, AP HP,Inserm,UMR 1152, Hop Bichat,Serv Pneumol & Ctr Reference Constitut, Paris, France

[13] Aix Marseille Univ, INSERM U1263, INRA 1260, C2VN, Marseille, France

[14] Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France

来源：

THERAPEUTIC ADVANCES IN RESPIRATORY DISEASE | 2021年 / 15卷

关键词：

anti-interleukin; 5; receptor; failure; severe asthma; EOSINOPHILIC ASTHMA; DECISION-MAKING; MEPOLIZUMAB; CORTICOSTEROIDS; BENRALIZUMAB;

D O I：

10.1177/17534666211049735

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Background: Current practices for assessing response to anti-interleukin 5/R treatment in severe asthma patients are heterogeneous. The objective of this study was to achieve an expert consensus defining failure criteria for anti-interleukin 5/R treatment in severe asthma patients. Methods: Experts were invited to a 5-round Delphi exercise if they were pulmonologists managing > 30 patients at a nationally recognized severe asthma expert centre. Following two rounds of statement-generating brainstorming, the expert panel ranked each statement according to a 5-point Likert-type scale during three additional rounds. Positive consensus was considered achieved when > 80% of experts agreed with a statement with >50% strong agreement and Results: Twenty experts participated in the study. All experts agreed that predefined treatment goals defining effectiveness should be personalized during shared decision making via a patient contract. Treatment failure was defined as (1) absence of a reduction in exacerbation rates by > 25% or (2) absence of a reduction in oral corticosteroid therapy by > 25% of the initial dosage or (3) occurrence of emergency room visits or hospitalizations after 6 months of treatment. Treatment failure should result in discontinuation. For partial responders, treatment discontinuation was not recommended unless an alternative from another therapeutic class exists and should be discussed in a multidisciplinary consultation. Conclusion: The present study provides objective criteria for anti IL5 or IL5R failure in severe asthma and suggests consensus based guidelines for prescription, evaluation and discontinuation decision-making.

引用

页数：14