دورية أكاديمية

Efficacy of Tezepelumab in Patients with Severe, Uncontrolled Asthma Across Multiple Clinically Relevant Subgroups in the NAVIGATOR Study.

التفاصيل البيبلوغرافية
العنوان: Efficacy of Tezepelumab in Patients with Severe, Uncontrolled Asthma Across Multiple Clinically Relevant Subgroups in the NAVIGATOR Study.
المؤلفون: Carr TF; Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA., Moore WC; Department of Internal Medicine, Section on Pulmonary, Critical Care, Allergy and Immunologic Diseases, Wake Forest School of Medicine, Winston-Salem, NC, USA., Kraft M; Department of Medicine, Icahn School of Medicine, Mount Sinai Health System, New York, NY, USA., Brusselle G; Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium., Castro M; Division of Pulmonary, Critical Care and Sleep Medicine, University of Kansas School of Medicine, Kansas City, KS, USA., Chupp GL; Yale Center for Asthma and Airway Disease, Yale School of Medicine, Yale University, New Haven, CT, USA., Wechsler ME; National Jewish Health, Denver, CO, USA., Hunter G; Biometrics, Late-Stage Development, Respiratory and Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK., Lindsley AW; US Medical Affairs, Amgen, Thousand Oaks, CA, USA., Llanos JP; Global Medical Affairs, Amgen, Thousand Oaks, CA, USA., Burke LK; Respiratory and Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK., Chandarana S; Respiratory and Immunology, BioPharmaceuticals Medical, AstraZeneca, 1 MedImmune Way, Gaithersburg, MD, 20878, USA., Ambrose CS; Respiratory and Immunology, BioPharmaceuticals Medical, AstraZeneca, 1 MedImmune Way, Gaithersburg, MD, 20878, USA. chris.ambrose@astrazeneca.com.
المصدر: Advances in therapy [Adv Ther] 2024 Jul; Vol. 41 (7), pp. 2978-2990. Date of Electronic Publication: 2024 May 27.
نوع المنشور: Journal Article; Randomized Controlled Trial; Clinical Trial, Phase III; Multicenter Study
اللغة: English
بيانات الدورية: Publisher: Health Communications Inc Country of Publication: United States NLM ID: 8611864 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1865-8652 (Electronic) Linking ISSN: 0741238X NLM ISO Abbreviation: Adv Ther Subsets: MEDLINE
أسماء مطبوعة: Publication: New York : Springer Healthcare Communications, 2008- : Health Communications Inc.
Original Publication: Metuchen, N.J. : Health Communications Inc., c1984-
مواضيع طبية MeSH: Asthma*/drug therapy , Antibodies, Monoclonal, Humanized*/therapeutic use , Anti-Asthmatic Agents*/therapeutic use, Humans ; Male ; Middle Aged ; Female ; Double-Blind Method ; Adult ; Aged ; Adolescent ; Young Adult ; Treatment Outcome ; Aged, 80 and over ; Child ; Severity of Illness Index
مستخلص: Introduction: Many patients with severe asthma continue to experience symptoms and exacerbations despite treatment with standard-of-care therapy. In the phase 3 NAVIGATOR study, tezepelumab significantly reduced exacerbations over 52 weeks compared with placebo in patients with severe, uncontrolled asthma. This analysis assessed the efficacy of tezepelumab in reducing asthma exacerbations in various clinically relevant subgroups of patients in NAVIGATOR.
Methods: NAVIGATOR was a phase 3, multicentre, randomized, double-blind, placebo-controlled study. Participants (12-80 years old) with severe, uncontrolled asthma were randomized 1:1 to receive tezepelumab 210 mg or placebo subcutaneously every 4 weeks for 52 weeks. Pre-specified and post hoc analyses were performed to evaluate the annualized asthma exacerbation rate (AAER) over 52 weeks in clinically relevant subgroups of patients defined by baseline patient characteristics, medical history, exacerbation triggers, medication eligibility and medication use before and during the study.
Results: Tezepelumab reduced the AAER over 52 weeks compared with placebo across a wide range of patient subgroups assessed. Reductions in exacerbations were similar across subgroups defined by baseline patient characteristics, ranging from 48% (95% confidence interval [CI]: 21, 65) to 60% (95% CI: 44, 71) in subgroups analysed by sex, smoking history and body mass index. Among the asthma-related comorbidity subgroups investigated, patients with aspirin or NSAID sensitivity had the greatest reductions in AAER with tezepelumab compared with placebo (83%; 95% CI: 66, 91). In patients eligible to receive dupilumab, tezepelumab reduced exacerbations compared with placebo by 64% (95% CI: 54, 71). Reductions in the AAER with tezepelumab compared with placebo were also observed irrespective of exacerbation trigger category and the number of asthma controller medications patients were receiving at baseline.
Conclusion: These findings further support the benefits of tezepelumab in patients with severe, uncontrolled asthma and can help to inform healthcare providers' treatment decisions.
Clinical Trial Registration: NAVIGATOR (NCT03347279).
(© 2024. The Author(s).)
References: Pediatr Allergy Immunol. 2022 Jan;33(1):e13655. (PMID: 34448255)
N Engl J Med. 2014 May 29;370(22):2102-10. (PMID: 24846652)
Am J Respir Crit Care Med. 2010 Feb 15;181(4):315-23. (PMID: 19892860)
Respir Res. 2020 Oct 13;21(1):266. (PMID: 33050934)
Lancet Respir Med. 2023 May;11(5):425-438. (PMID: 36702146)
J Asthma Allergy. 2023 Sep 04;16:915-932. (PMID: 37692126)
J Allergy Clin Immunol. 2017 Jun;139(6):1797-1807. (PMID: 27773852)
Clin Exp Allergy. 2023 Apr;53(4):417-428. (PMID: 36507576)
Medicine (Baltimore). 2016 May;95(22):e3459. (PMID: 27258489)
Ann Allergy Asthma Immunol. 2023 Nov;131(5):587-597.e3. (PMID: 37619779)
J Allergy Clin Immunol Pract. 2021 Jul;9(7):2680-2688.e7. (PMID: 33744476)
Am J Respir Crit Care Med. 2001 Oct 15;164(8 Pt 2):S1-5. (PMID: 11704610)
Ann Allergy Asthma Immunol. 2024 Jan;132(1):42-53. (PMID: 37640263)
Expert Rev Respir Med. 2011 Jun;5(3):377-93. (PMID: 21702660)
Am J Respir Crit Care Med. 2017 Feb 1;195(3):302-313. (PMID: 27556234)
Nat Rev Immunol. 2023 Jan;23(1):24-37. (PMID: 35650271)
J Investig Allergol Clin Immunol. 2024 Apr 12;34(2):97-105. (PMID: 36420740)
Clin Exp Allergy. 2021 Apr;51(4):546-555. (PMID: 33217063)
Allergy. 2024 May;79(5):1134-1145. (PMID: 38146651)
Sci Rep. 2020 Jun 9;10(1):9274. (PMID: 32518278)
N Engl J Med. 2021 May 13;384(19):1800-1809. (PMID: 33979488)
Clin Exp Otorhinolaryngol. 2018 Jun;11(2):71-80. (PMID: 29642688)
Curr Med Res Opin. 2018 Dec;34(12):2075-2088. (PMID: 30047292)
Expert Opin Ther Targets. 2020 Aug;24(8):777-792. (PMID: 32567399)
Eur Respir J. 2014 Feb;43(2):343-73. (PMID: 24337046)
Am J Respir Crit Care Med. 2020 Feb 1;201(3):276-293. (PMID: 31525297)
Ann Allergy Asthma Immunol. 2016 Jan;116(1):37-42. (PMID: 26707771)
Am J Respir Crit Care Med. 2023 Jul 1;208(1):13-24. (PMID: 37015033)
فهرسة مساهمة: Keywords: Asthma; Biologics; Comorbidities; Exacerbation; Severe asthma; Tezepelumab
سلسلة جزيئية: ClinicalTrials.gov NCT03347279
المشرفين على المادة: 0 (Antibodies, Monoclonal, Humanized)
RJ1IW3B4QX (tezepelumab)
0 (Anti-Asthmatic Agents)
تواريخ الأحداث: Date Created: 20240527 Date Completed: 20240628 Latest Revision: 20240726
رمز التحديث: 20240726
مُعرف محوري في PubMed: PMC11213736
DOI: 10.1007/s12325-024-02889-8
PMID: 38802635
قاعدة البيانات: MEDLINE
الوصف
تدمد:1865-8652
DOI:10.1007/s12325-024-02889-8