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DOI: 10.1055/s-0037-1619157
Asthma Symptom Improvements with Benralizumab are Associated with Improvements in Activity Function and Quality of Life for Patients with Severe, Uncontrolled Asthma
Publication History
Publication Date:
21 February 2018 (online)
Introduction:
Benralizumab is a humanized, anti-eosinophilic monoclonal antibody that improves exacerbations and daily symptoms in patients (pts) with severe, uncontrolled eosinophilic asthma. This study investigated the association of asthma symptom improvements with activity impairment assessments and quality of life (QOL).
Methods:
Analysis of pooled data for adult pts with severe asthma receiving high-dosage ICS/LABA in the Phase III SIROCCO (Lancet. 2016;388:2115 – 27) and CALIMA (Lancet. 2016;388:2128 – 41) trials. Pts received benralizumab (n = 1,474 total) or placebo (n = 742). Daily asthma symptoms; daily activity function (activity limitations, activity avoidance, need to pace oneself during activities); feeling stress; feeling tired; rescue medication use; night-time awakenings; Asthma Control Questionnaire 6 (ACQ-6); and Standardized Asthma QOL Questionnaire for pts ≥12yrs (AQLQ[S]+12) were captured with an electronic diary. Spearman's rank correlation coefficient was used to assess daily asthma symptoms association with diary items and FEV1 at baseline and end of treatment. Associations of < 0.2, 0.2–< 0.4, 0.4–< 0.6, 0.6–< 0.8, and 0.8 – 1.0 were considered “very weak,” “weak,” “moderate,” “strong,” and “very strong,” respectively.
Results:
Associations were observed between asthma symptoms and daily activity function items, daily stress, ACQ-6, AQLQ(S)+12 overall and domain scores, and FEV1 in both benralizumab and placebo arms (table). Strong correlations were observed between daily symptoms and daily assessments of activity function items (r = 0.66 – 0.77), feeling tired (r = 0.66 – 0.76), and ACQ-6 scores (r = 0.58 – 0.68) at baseline and change from baseline to end of treatment. Moderate correlations were observed between symptom scores and feeling stressed (r = 0.36 – 0.50); rescue medication use (r = 0.49 – 0.57); and AQLQ(S)+12 domains: overall, symptoms, activity limitation, and emotional domains (r = –0.41 to –0.62). Benralizumab-treated pts had a better correlation between symptom improvement and FEV1 improvement compared with placebo (r = –0.21 vs. –0.13).
Variables For Correlation |
Baseline |
Change From Baseline to End of Treatment |
||
Benralizumab |
Placebo |
Benralizumab |
Placebo |
|
Daily diary assessments |
||||
Activity function: limitation of activities |
0.77 |
0.76 |
0.73 |
0.66 |
Activity function: avoidance of activities |
0.76 |
0.73 |
0.72 |
0.67 |
Activity function: need to pace self |
0.76 |
0.72 |
0.71 |
0.66 |
Feeling tired |
0.76 |
0.72 |
0.70 |
0.66 |
Feeling stressed |
0.50 |
0.48 |
0.49 |
0.36 |
Percentage of night-time awakening |
0.65 |
0.62 |
0.48 |
0.45 |
Total rescue medication use (puffs per day) |
0.57 |
0.56 |
0.51 |
0.49 |
ACO-6 score |
0.68 |
0.68 |
0.64 |
0.58 |
AQLQ(S)+12 |
||||
Overall |
-0.60 |
-0.55 |
-0.61 |
-0.52 |
Symptoms |
-0.62 |
-0.59 |
-0.61 |
-0.53 |
Activity limitation |
-0.54 |
-0.50 |
-0.55 |
-0.48 |
Emotional function |
-0.47 |
-0.44 |
-0.54 |
-0.41 |
Environmental stimulation |
-0.37 |
-0.33 |
-0.42 |
-0.35 |
Prebronchodilator FEV1 (L) |
-0.09 |
-0.08 |
-0.21 |
-0.13 |
ACQ-6, Asthma Control Questionnaire 6; AQLQ(S)+12, Standardized Asthma Quality of Life Questionnaire for patients 12 years and older; FEV1, forced expiratory volume in 1 second. All p< 0.05. |
Conclusions:
Asthma-related symptoms and improvements are associated with other important aspects of improvement in patient well-being, especially in those with severe, uncontrolled asthma receiving optimal care.
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