Evidence map›Paper›PMID 39260678›Full record

ArticleRespiratory medicine

Temporal variation in the effectiveness of biologics in asthma: Effect modification by changing patient characteristics.

Tanawin Nopsopon, Alyson Brown, Georg Hahn, Matthew Rank, Krista F Huybrechts, Ayobami Akenroye

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Respiratory medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Tanawin NopsoponDivision of Allergy and Clinical Immunology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Alyson BrownDivision of Allergy and Clinical Immunology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Georg HahnDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Matthew RankMayo Clinic in Arizona and Phoenix Children's Hospital, Scottsdale and Phoenix, AZ, USA.
Krista F HuybrechtsDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Ayobami AkenroyeDivision of Allergy and Clinical Immunology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA. Electronic address: aakenroye@bwh.harvard.edu.

Funding

Synthesizing Trial and Real-world Data on the Use of Biologics in Patients with Severe AsthmaR00MD015767 · NIMHD · BRIGHAM AND WOMEN'S HOSPITAL · PI AKENROYE, AYOBAMI T · 2023 to 2025
$677k
NHLBI NIH HHS L30 HL165481NIMHD NIH HHS R00 MD015767
6 · The paper itself

Abstract

backgroundThe underlying population of patients selected for each respiratory monoclonal antibody might change as other biologics are approved.

objectiveTo evaluate effect modification by calendar time of the effectiveness of each respiratory biologics in asthma.

methodsThe Effectiveness of Respiratory biologics in Asthma (ERA) is a retrospective cohort of severe asthma patients from the Mass General Brigham clinics between January 2013 and September 2023. Periods were pre-specified as the anti-IgE (2013-2015), anti-IL5 (2016-2018), anti-IL4/13 (2019-2021) or anti-alarmin (2022-2023) era. We evaluated each biologic's effect on asthma-related exacerbations comparing the one-year period before and after therapy initiation using Poisson regression and Cox regression for time-to-first exacerbation.

resultsOf 647 biologic-naïve patients, 165 initiated omalizumab, 235 anti-IL5, 227 dupilumab, and 20 tezepelumab. Omalizumab's effectiveness improved as more biologics were approved: incidence rate ratio (IRR) 1.16 [0.94-1.43] anti-IgE era vs. 0.54 [0.37-0.80] anti-IL4/13-alarmin era. Omalizumab patients in the anti-IL4/13-alarmin era had lower blood eosinophil counts and less chronic rhinosinusitis with nasal polyps (CRSwNP). For anti-IL5s, effectiveness peaked in the anti-IL4/13 era (IRR 0.52 [0.42-0.64]) when patients had higher BMI and less concomitant CRSwNP. Dupilumab was most effective in the anti-IL4/13 era (IRR 0.60 [0.50-0.72]). There were fewer current smokers in dupilumab patients in the anti-IL4/13 era. Results were similar in time-to-event analyses and in sensitivity analyses accounting for the COVID-19 pandemic.

conclusionThere are temporal variations in the effectiveness of biologics partly explained by the shift in the underlying population, particularly for omalizumab. Though having more choices was associated with better patient selection for omalizumab, this was inconsistent for other biologics.

Indexed as

Anti-Asthmatic AgentsAsthmaBiological ProductsAdultAntibodies, Monoclonal, HumanizedFemaleHumansMaleMiddle AgedOmalizumabRetrospective StudiesTime FactorsTreatment OutcomeAnti-Asthmatic AgentsAntibodies, Monoclonal, HumanizedBiological ProductsOmalizumabAsthmaBenralizumabBiologicsDupilumabEffect modificationMepolizumabMonoclonal antibodiesOmalizumabReslizumabTezepelumab

Identifiers

PMID39260678
PMCPMC11588503

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.