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Advanced Management Strategies in Severe Asthma an ...
Evidence from Recent Studies Khurana
Evidence from Recent Studies Khurana
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The "Master Class: Advanced Management Strategies in Severe Asthma and COPD" by Dr. Sandhya Khurana presents recent evidence from clinical trials exploring advanced asthma therapies, including biologics. The lecture discusses topics such as biologic continuation versus cessation, the role of biologics in mucus production and acute exacerbations, and strategies for stepping down therapy to achieve on-treatment remission.<br /><br />Key teaching points center around biologics targeting various proteins and cytokines involved in asthma pathophysiology such as IgE, IL-5, IL-5R, IL-4R, and TSLP. These biologics, including Omalizumab, Mepolizumab, Reslizumab, Benralizumab, Dupilumab, and Tezepelumab, are evaluated for their effectiveness in reducing exacerbations and dependency on oral corticosteroids (OCS). The summary clarifies that Benralizumab results in rapid depletion of eosinophils, a priority for addressing eosinophilic exacerbations of asthma and COPD.<br /><br />The discussion includes findings from various studies, such as the DESTINATION trial, which evaluated Tezepelumab, and the SWIFT trials examining Depemokimab, emphasizing reduced annual exacerbation rates and increased time to first exacerbation. Additionally, Porsbjerg et al.'s research on Dupilumab shows a reduction in mucus plugging, while the CASCADE trial explores Tezepelumab's effects on mucus.<br /><br />Importantly, the text highlights that discontinuing biologic therapy may lead to a rise in T2 biomarkers and loss of asthma control. However, a proportion of patients might achieve remission, potentially allowing stepping down of therapy, supported by evidence from the OPTIMAL study. This research indicates that with proper management, many patients might reduce or even discontinue biologic therapy successfully.<br /><br />Overall, effective long-acting biologics such as Depemokimab have shown potential to enhance adherence and reduce the treatment burden. These insights could guide clinicians in tailoring asthma and COPD management effectively to patient needs.
Keywords
severe asthma
COPD
Chronic Obstructive Pulmonary Disease
biologics
clinical trials
eosinophils
mucus production
exacerbations
Omalizumab
Tezepelumab
Dupilumab
COPD
Chronic Obstructive Pulmonary Disease
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