Clinical response to biologicals for severe asthma: any relevance for sex in different age ranges?

Roberto Benoni; Silvia Panunzi; Veronica Batani; Francesca Moretti; Stefano Fuggini; Mattia Todesco; Gianenrico Senna; Albino Poli; Andrea Vianello; Marco Caminati

doi:10.1183/23120541.00670-2021

Clinical response to biologicals for severe asthma: any relevance for sex in different age ranges?

ERJ Open Res. 2022 Jul 18;8(3):00670-2021. doi: 10.1183/23120541.00670-2021. eCollection 2022 Jul.

Authors

Affiliations

¹ Section of Hygiene, Dept of Diagnostics and Public Health, University of Verona, Verona, Italy.
² Unit of Epidemiology and Medical Statistics, Dept of Diagnostics and Public Health, University of Verona, Verona, Italy.
³ Dept of Medicine, University of Verona, Verona, Italy.
⁴ Asthma Center and Allergy Unit, Verona University Hospital, Verona, Italy.
⁵ Respiratory Pathophysiology Unit, Dept of Cardiological, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.

Abstract

Background: Whether sex can influence the clinical response to biological treatment in patients with severe asthma has not been fully addressed.

Aims and methods: The aim of this study was to investigate in patients with severe asthma undergoing biological treatment the individual evolution of lung function measurements and patient-reported asthma control scores over a 12-month follow-up period, in relation to patients' sex, in different age ranges. Second, the change in the administered dose of oral corticosteroids (OCS) before and after 12 months of treatment was investigated.

Results: 64 patients (58% female and 42% male) with a median age of 52 years were enrolled in the study. There were no relevant differences between sexes in terms of lung function, patient-reported asthma control, exacerbation rate and daily OCS dose within the study timeframe. A separate sub-analysis by biological treatment confirmed the same finding. Stratifying individuals by age, we showed that older men had lower lung function parameter values (forced expiratory volume in 1 s (FEV₁) % predicted and FEV₁/forced vital capacity index) than older women, whereas an opposite trend was observed in terms of Asthma Control Test score. No other relevant differences were detected after age stratification.

Conclusion: According to our findings, sex does not act as a determinant of treatment response to biologicals in people with severe asthma. Although to be confirmed in larger studies, our data suggest that neither sex nor age should limit biological treatment prescription, once the eligibility criteria for that therapy are satisfied.