Related Experiment Video
Updated: Jun 13, 2025
Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
Response to Biologic Therapy in Patients with Asthma and Reduced Pulmonary Diffusion Capacity
Leonie Biener1, Hussein Morobeid1, Carmen Pizarro1
1Department of Internal Medicine II, Cardiology, Pneumology, Angiology, University Hospital of Bonn, Bonn, Germany.
Introduction:
Asthma patients with a smoking history are usually excluded from asthma trials to exclude smoking-related comorbidities like chronic obstructive pulmonary disease (COPD). Therefore, little is known about the efficacy of biologic therapy in asthma patients with reduced diffusing capacity of the lungs for carbon monoxide (DLCO).
Methods:
This study aimed to assess the response to biologic therapy in asthma patients with reduced DLCO. A total of 77 consecutive patients undergoing biologic therapy in a routine clinical setting were included in the analysis and divided into three groups: DLCO ≥60%, DLCO <60% and <10 pack-years, and DLCO <60% and ≥10 pack-years = asthma and COPD comorbidity. Follow-up evaluations were conducted after a minimum of 6 months of therapy.
Results:
After 34.0 ± 10.2 weeks, comparable therapeutic responses were observed between the three groups. There were no differences between the groups in terms of reduction in the annual acute exacerbation rate (AE median -3 [25th percentile -5; 75th percentile -1] vs. -6.1 [-11.3;-2.2] vs. -3 [-6;-2], p = 0.067), oral corticosteroid (OCS) doses (-5 [-10;0] vs. -1 [-7.5;0] vs. -7.5 [-10;-4] mg, p = 0.136), improvement in Asthma Control Test (ACT) scores (4 [0;9.3] vs. 3 [-1;6] vs. 4 [3;10], p = 0.276) or forced expiratory volume in 1 s (FEV1) improvement (5.5 [-2;21.5] vs. 0.5 [-2.8;9.3] vs. 5 [0;16] % predicted, p = 0.328). Linear regression analysis revealed no significant correlation between DLCO levels and changes in OCS dosage or AE rate, nor between DLCO and improvements in ACT scores or FEV1. Notably, a smaller proportion of patients exhibited a reduced transfer coefficient (DLCO/VA) (n = 13, 16.9%). This parameter did not significantly impact therapy response either.
Conclusion:
Our findings suggest that biologic therapy can effectively manage asthma irrespective of DLCO measurements. Thus, reduced DLCO values should not preclude thorough asthma diagnosis and treatment. Further investigation into the utility of DLCO/VA assessment in this context is warranted.
Related Concept Videos
01:17Drugs Used in Lower Respiratory Disorders: Overview
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
01:26COPD: Management Using Bronchodilators and Corticosteroids
01:25Antiasthma Drugs: β2-Adrenoceptor Agonists
One class of bronchodilators includes β2-adrenoceptor agonists. These agents target the β2-adrenoceptors located on bronchial smooth muscle cells. By stimulating these receptors, β2-agonists induce...
01:25Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
01:25Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes: