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Article Dans Une Revue Therapeutic Advances in Respiratory Disease Année : 2021

Anti-interleukin 5 therapies failure criteria in severe asthma: a Delphi-consensus study

Laura Mattei (1) , Carey Suehs (2, 3) , Khuder Alagha (4, 2, 3) , Arnaud Bourdin (5, 3, 2, 6) , Christophe Brousse (3, 2, 4) , Jérémy Charriot (5, 3, 2) , Gilles Devouassoux (6, 7, 8, 9) , Stephanie Fry (6, 10, 11, 12) , Laurent Guilleminault (6, 13, 14) , Marion Gouitaa (15, 16) , Camille Taille (6, 17, 18) , Pascal Chanez (6, 15, 16, 19) , Laurie Pahus (6, 15, 16, 19, 20)
Laura Mattei

Résumé

Background: Current practices for assessing response to anti-interleukin 5/R treatment in severe asthma patients are heterogeneous. The objective of this study was to achieve an expert consensus defining failure criteria for anti-interleukin 5/R treatment in severe asthma patients. Methods: Experts were invited to a 5-round Delphi exercise if they were pulmonologists managing ⩾30 patients at a nationally recognized severe asthma expert centre. Following two rounds of statement-generating brainstorming, the expert panel ranked each statement according to a 5-point Likert-type scale during three additional rounds. Positive consensus was considered achieved when ⩾80% of experts agreed with a statement with >50% strong agreement and <15% disagreement. Results: Twenty experts participated in the study. All experts agreed that predefined treatment goals defining effectiveness should be personalized during shared decision making via a patient contract. Treatment failure was defined as (1) absence of a reduction in exacerbation rates by ⩾25% or (2) absence of a reduction in oral corticosteroid therapy by ⩾25% of the initial dosage or (3) occurrence of emergency room visits or hospitalizations after 6 months of treatment. Treatment failure should result in discontinuation. For partial responders, treatment discontinuation was not recommended unless an alternative from another therapeutic class exists and should be discussed in a multidisciplinary consultation. Conclusion: The present study provides objective criteria for anti IL5 or IL5R failure in severe asthma and suggests consensus based guidelines for prescription, evaluation and discontinuation decision-making.
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hal-03374389 , version 1 (12-10-2021)

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Laura Mattei, Carey Suehs, Khuder Alagha, Arnaud Bourdin, Christophe Brousse, et al.. Anti-interleukin 5 therapies failure criteria in severe asthma: a Delphi-consensus study. Therapeutic Advances in Respiratory Disease, 2021, 15, pp.175346662110497. ⟨10.1177/17534666211049735⟩. ⟨hal-03374389⟩
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