Development of a Tool to Measure the Clinical Response to Biologic Therapy in Uncontrolled Severe Asthma: The FEV1, Exacerbations, Oral Corticosteroids, Symptoms Score
Por:
de Llano, LP, Davila, I, Martinez-Moragon, E, Dominguez-Ortega, J, Almonacid, C, Colas, C, Garcia-Rivero, JL, Carmona, L, de Yebenes, MJG, Cosio, BG, Torrego A., MENA, ALICIA HABERNAU
Publicada:
1 jul 2021
Ahead of Print:
1 jul 2021
Resumen:
BACKGROUND: There is a lack of tools to quantify the response to monoclonal antibodies (mAbs) holistically in severe uncontrolled asthma patients. OBJECTIVE: To develop a valid score to assist specialists in this clinical context. METHODS: The score was developed in four subsequent phases: (1) elaboration of the theoretical model of the construct intended to be measured (response to mAbs); (2) definition and selection of items and measurement instruments by Delphi survey; (3) weight assignment of the selected items by multicriteria decision analysis using the Potentially All Pairwise RanKings of All Possible Alternatives methodology using the 1000minds software; and (4) face validity assessment of the obtained score. RESULTS: Four core items, with different levels of response for each, were selected: severe exacerbations, oral corticosteroid use, symptoms (evaluated by Asthma Control Test), and bronchial obstruction (assessed by FEV1 percent predicted). Severe exacerbations and oral corticosteroid maintenance dose were weighted most heavily (38% each), followed by symptoms (13%) and FEV1 (11%). Higher scores in the weighted system indicate a better response and the range of responses runs from 0 (worsening) to 100 (best possible response). Face validity was high (intraclass correlation coefficient of 0.86). CONCLUSIONS: The FEV1, exacerbations, oral corticosteroids, symptoms score allows clinicians to quantify response in severe uncontrolled asthma patients who are being treated with mAbs.(c) 2021 American Academy of Allergy, Asthma & Immunology (J Allergy Clin Immunol Pract 2021;9:2725-31)
Filiaciones:
de Llano, LP:
EOXI Lugo, Hosp Lucus Augusti, Pneumol Serv, Lugo, Spain
Davila, I:
Univ Hosp Samanca, Dept Allergy, Salamanca, Spain
Martinez-Moragon, E:
Hosp Univ Dr Peset, Pneumol Serv, Valencia, Spain
Dominguez-Ortega, J:
La Paz Hosp, Allergy Dept, Inst Hlth Res, Madrid, Spain
CIBER Resp Dis CIBERES, Madrid, Spain
Almonacid, C:
Hosp Ramon & Cajal, Pneumol Serv, Irycis, Madrid, Spain
Colas, C:
Hosp Clin Inst Invest Sanitaria Aragon, Zaragoza, Spain
Garcia-Rivero, JL:
Hosp Laredo, Dept Resp Med, Cantabria, Spain
Carmona, L:
Inst Salud Musculoesquelet, Madrid, Spain
de Yebenes, MJG:
Inst Salud Musculoesquelet, Madrid, Spain
Cosio, BG:
Hosp Univ Son Espases IdISBa Ciberes, Dept Resp Med, Palma De Mallorca, Spain
Torrego A.:
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
MENA, ALICIA HABERNAU:
Complejo Hospitalario de Mérida, Merida, Spain
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