Evidence map›Paper›PMID 39922604›Full record

Observational studyBMJ open respiratory research2025

Effects of biologic therapy on novel indices of lung inhomogeneity in patients with severe type-2 high asthma.

Asma Alamoudi, Lorenzo Petralia, Nicholas M J Smith, Haopeng Xu, Dominic Sandhu, Graham Richmond, Nick P Talbot, Grant Ad Ritchie, Ian Pavord, Peter A Robbins and 1 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMJ open respiratory research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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

1 citing paper in PubMed.

  1. From FEVJournal of asthma and allergy · 2026
    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

11 authors.

Asma AlamoudiDepartment of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK.
Lorenzo PetraliaDepartment of Chemistry, Physical and Theoretical Chemistry Laboratory, University of Oxford, Oxford, UK.
Nicholas M J SmithDepartment of Chemistry, Physical and Theoretical Chemistry Laboratory, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0003-3206-9793
Haopeng XuNuffield Department of Medicine, University of Oxford, Oxford, UK.
Dominic SandhuDepartment of Chemistry, Physical and Theoretical Chemistry Laboratory, University of Oxford, Oxford, UK.
Graham RichmondDepartment of Chemistry, Physical and Theoretical Chemistry Laboratory, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0003-2999-5067
Nick P TalbotDepartment of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0002-9186-8950
Grant Ad RitchieDepartment of Chemistry, Physical and Theoretical Chemistry Laboratory, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0003-1663-7770
Ian PavordNuffield Department of Medicine, University of Oxford, Oxford, UK.
Peter A RobbinsDepartment of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0002-4975-0609
Nayia PetousiNuffield Department of Medicine, University of Oxford, Oxford, UK nayia.petousi@ndm.ox.ac.uk.ORCID http://orcid.org/0000-0002-5524-020X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

INTRODUCTION/

aimLung inhomogeneity measures obtained using computed cardiopulmonography (CCP) are sensitive to small-airways disease. Here, we assessed changes in lung inhomogeneity in patients with type-2 high asthma treated with biological therapy and explored the relationship between inhomogeneity measures and conventional asthma disease markers.

methodsThis was an observational study of 91 severe type-2 high asthma patients recruited from a tertiary asthma clinic, of whom 67 subsequently started anti-IL5 or anti-IL5R biologics. Patients were evaluated at baseline and, 54 of those commencing biologics, at their fourth injection with either mepolizumab or benralizumab. Assessments included prebronchodilator and postbronchodilator CCP and spirometry, and measurements of blood eosinophil count (BEC), fractional exhaled nitric oxide and Asthma-Symptom Questionnaire (ACQ-5).

resultsBronchodilation significantly reduced σlnCl, a novel CCP-derived ventilation inhomogeneity index, (ΔσlnCl -0.08, 95% CI (-0.10 to -0.05), p<0.001). Baseline σlnCl, but not forced expiratory volume in 1 s (FEV

conclusionσlnCl is strongly associated with systemic eosinophilic inflammation in severe type-2 high asthma. An early σlnCl response following anti-IL5 biologics identifies patients more likely to experience improvements in symptoms and lung function when systemic eosinophils are depleted. σlnCl may provide a sensitive route for tracking inflammation involving the small airways.

Indexed as

Anti-Asthmatic AgentsAntibodies, Monoclonal, HumanizedAsthmaBiological TherapyLungAdultAgedEosinophilsFemaleForced Expiratory VolumeFractional Exhaled Nitric Oxide TestingHumansMaleMiddle AgedSeverity of Illness IndexSpirometryAnti-Asthmatic AgentsAntibodies, Monoclonal, HumanizedbenralizumabmepolizumabAsthmaLung PhysiologyRespiratory Measurement

Identifiers

PMID39922604
PMCPMC11808925

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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.