Forced oscillation technique as method to document and monitor the efficacy of mepolizumab in treating severe eosinophilic asthma

Antonicelli, Leonardo; Tontini, Chiara; Marchionni, Aureliano; Lucchetti, Beatrice; Garritani, M. S.; Bilò, Maria Beatrice

doi:10.1111/all.13938

Cited by 17 publications

(11 citation statements)

References 11 publications

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“…One study has attempted to determine whether oscillometry could distinguish any benefit of small versus large particle size ICS therapy based on peripheral versus central airway obstruction, respectively; however, this study only looked at the differential treatment effect on symptoms, not oscillometry, and used an arbitrary oscillometric definition of peripheral airway function [83]. Oscillometric indices are also sensitive to improvements in asthma in response to mepolizumab therapy [84]. These findings suggest an important role of oscillometry in identifying and monitoring treatment responses in asthma, complementary to traditional spirometry.…”

Section: Treatment Responses In Asthmamentioning

confidence: 99%

Clinical significance and applications of oscillometry

Kaminsky

Simpson

Berger³

et al. 2022

Eur Respir Rev

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Recently, “Technical standards for respiratory oscillometry” was published, which reviewed the physiological basis of oscillometric measures and detailed the technical factors related to equipment and test performance, quality assurance and reporting of results. Here we present a review of the clinical significance and applications of oscillometry. We briefly review the physiological principles of oscillometry and the basics of oscillometry interpretation, and then describe what is currently known about oscillometry in its role as a sensitive measure of airway resistance, bronchodilator responsiveness and bronchial challenge testing, and response to medical therapy, particularly in asthma and COPD. The technique may have unique advantages in situations where spirometry and other lung function tests are not suitable, such as in infants, neuromuscular disease, sleep apnoea and critical care. Other potential applications include detection of bronchiolitis obliterans, vocal cord dysfunction and the effects of environmental exposures. However, despite great promise as a useful clinical tool, we identify a number of areas in which more evidence of clinical utility is needed before oscillometry becomes routinely used for diagnosing or monitoring respiratory disease.

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Section: Treatment Responses In Asthmamentioning

confidence: 99%

Clinical significance and applications of oscillometry

Kaminsky

Simpson

Berger³

et al. 2022

Eur Respir Rev

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“…For benralizumab, Mathur et al found several indicators of enhanced response of the drug in two phase III trials in patients with elevated blood eosinophil counts, decreased lung function, long‐term oral corticosteroid use, and nasal polyposis 170 . In a small prospective study, Antonicelli et al showed that forced oscillation technique (a noninvasive method that provides information of the degree of obstruction of the respiratory system) could detect specific mepolizumab‐induced changes in peripheral airway function in patients undergoing treatment for severe eosinophilic asthma 171 …”

Section: Novel Treatments Driven By Asthma Endotypesmentioning

confidence: 99%

Advances and recent developments in asthma in 2020

Cevhertas

Öğülür

Maurer

et al. 2020

Allergy

118

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In this review, we discuss recent publications on asthma and review the studies that have reported on the different aspects of the prevalence, risk factors and prevention, mechanisms, diagnosis, and treatment of asthma. Many risk and protective factors and molecular mechanisms are involved in the development of asthma. Emerging concepts and challenges in implementing the exposome paradigm and its application in allergic diseases and asthma are reviewed, including genetic and epigenetic factors, microbial dysbiosis, and environmental exposure, particularly to indoor and outdoor substances. The most relevant experimental studies further advancing the understanding of molecular and immune mechanisms with potential new targets for the development of therapeutics are discussed. A reliable diagnosis of asthma, disease endotyping, and monitoring its severity are of great importance in the management of asthma. Correct evaluation and management of asthma comorbidity/ multimorbidity, including interaction with asthma phenotypes and its value for the precision medicine approach and validation of predictive biomarkers, are further detailed. Novel approaches and strategies in asthma treatment linked to mechanisms and endotypes of asthma, particularly biologicals, are critically appraised. Finally, due to the recent pandemics and its impact on patient management, we discuss the challenges, relationships, and molecular mechanisms between asthma, allergies, SARS-CoV-2, and COVID-19.

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“…IOS-defined SAD may be modified by biologics, and particularly antiIL-5 monoclonal antibody mepolizumab was able to improve lung ventilation heterogeneity indexes in subjects with severe asthma after treatment [ 119 , 120 ]. Antonicelli and colleagues evaluated the role of FOT in monitoring the effects of mepolizumab treatment in severe eosinophilic asthma, which correlated with both eosinophil counts and asthma control scores [ 121 ]. Controlling eosinophilic bronchitis with anti-T2 therapies improves ventilation defects, measured by inhaled gas MRI, in adults with prednisone-dependent asthma [ 122 ].…”

Section: Introductionmentioning

confidence: 99%

Small airway dysfunction and poor asthma control: a dangerous liaison

Cottini¹,

Licini²,

Lombardi

et al. 2021

Clin Mol Allergy

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Asthma is a common chronic condition, affecting approximately 339 million people worldwide. The main goal of the current asthma treatment guidelines is to achieve clinical control, encompassing both the patient symptoms and limitations and the future risk of adverse asthma outcomes. Despite randomized controlled trials showing that asthma control is an achievable target, a substantial proportion of asthmatics remain poorly controlled in real life. The involvement of peripheral small airways has recently gained greater recognition in asthma, and many studies suggest that the persistent inflammation at these sites leads to small airway dysfunction (SAD), strongly contributing to a worse asthma control. Overall, the impulse oscillometry (IOS), introduced in the recent years, seems to be able to sensitively assess small airways, while conventional spirometry does not. Therefore, IOS may be of great help in characterizing SAD and guiding therapy choice. The aim of this article is to review the literature on SAD and its influence on asthma control, emphasizing the most recent evidence.

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Forced oscillation technique as method to document and monitor the efficacy of mepolizumab in treating severe eosinophilic asthma

Cited by 17 publications

References 11 publications

Clinical significance and applications of oscillometry

Clinical significance and applications of oscillometry

Advances and recent developments in asthma in 2020

Small airway dysfunction and poor asthma control: a dangerous liaison

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