EAACI Biologicals Guidelines – Recommendations for severe asthma

Ioana Agache; Cezmi Akdis; Mubeccel Akdis; Giorgio Walter Canonica; Thomas Casale; Tomas Chivato; Jonathan Corren; Derek K. Chu; Stefano Del Giacco; Thomas Eiwegger; Breda Flood; Davide Firinu; James E. Gern; Eckard Hamelmann; Nicola Hanania; Irene Hernández‐martín; Rebeca Knibb; Mika Mäkelä; Parameswaran Nair; Liam O13037mahony; Nikolaos G. Papadopoulos; Alberto Papi; Hae‐sim Park; Luis Pérez De Llano; Oliver Pfaar; Santiago Quirce; Joaquin Sastre; Mohamed Shamji; Jurgen Schwarze; Oscar Palomares; Marek Jutel

doi:10.1111/all.14425

EAACI Biologicals Guidelines – Recommendations for severe asthma

Ioana Agache
, Cezmi Akdis
, Mubeccel Akdis
, Giorgio Walter Canonica
, Thomas Casale
, Tomas Chivato
, Jonathan Corren
, Derek K. Chu
, Stefano Del Giacco
, Thomas Eiwegger
, Breda Flood
, Davide Firinu
, James E. Gern
, Eckard Hamelmann
, Nicola Hanania
, Irene Hernández‐martín
, Rebeca Knibb
, Mika Mäkelä
, Parameswaran Nair
, Liam O13037mahony

Nikolaos G. Papadopoulos, Alberto Papi, Hae‐sim Park, Luis Pérez De Llano, Oliver Pfaar, Santiago Quirce, Joaquin Sastre, Mohamed Shamji, Jurgen Schwarze, Oscar Palomares, Marek Jutel

Transylvania University Faculty of Medicine Brasov Romania
Christine‐Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
Personalized Medicine, Asthma and Allergy Humanitas Clinical and Research Center IRCCS Rozzano Italy
Division of Allergy and Immunology University of South Florida Morsani College of Medicine Tampa FL USA
School of Medicine University CEU San Pablo Madrid Spain
David Geffen School of Medicine at UCLA Los Angeles USA
Department of Health Research Methods, Evidence and Impact Division of Immunology and Allergy Department of Medicine McMaster University Hamilton Ontario Canada
Department of Medical Sciences and Public Health University of Cagliari Italy
Division of Immunology and Allergy Food Allergy and Anaphylaxis Program The Hospital for Sick Children Departments of Paediatrics and Immunology University of Toronto Toronto Canada
European Federation of Allergy and Airway Diseases
Department of Pediatrics University of Wisconsin School of Medicine and Public Health
Children13037s Center Bethel Evangelical Hospital Bethel University of Bielefeld Germany
Section of Pulmonary, Critical Care and Sleep Medicine Baylor College of Medicine Houston Texas USA
Department of Allergy Hospital Universitario La Paz Madrid Spain
Skin and Allergy Hospital Helsinki University Hospital and University of Helsinki Finland
Division of Respirology Department of Medicine McMaster University, Hamilton, ON, Canada; Firestone Institute for Respiratory Health, St Joseph's Healthcare Hamilton ON Canada
Departments of Medicine and Microbiology APC Microbiome Ireland University College Cork Cork Ireland
Allergy Dpt 2<sup>nd</sup> Pediatric Clinic National Kapodistrian University of Athens Athens Greece
Research Center on Asthma and COPD Department of Medical Sciences University of Ferrara Ferrara Italy
Department of Allergy and Clinical Immunology Ajou University South Korea
Department of Respiratory Medicine Hospital Lucus Augusti Lugo Spain
Department of Otorhinolaryngology, Head and Neck Surgery Section of Rhinology and Allergy University Hospital Marburg Philipps‐Universität Marburg Marburg Germany
Department of Allergy La Paz University Hospital, IdiPAZ, CIBER of Respiratory Diseases (CIBERES), Universidad Autónoma de Madrid Spain
Universidad Autónoma de Madrid Facultad de Medicina
Imperial College NIHR Biomedical Research Centre Asthma UK Centre in Allergic Mechanisms of Asthma London United Kingdom
Centre for Inflammation Research Child Life and Health The University of Edinburgh Edinburgh United Kingdom
Department of Biochemistry and Molecular Biology Chemistry School Complutense University of Madrid Spain
ALL‐MED” Medical Research Institute Wroclaw Poland

Research output: Contribution to journal › Article › peer-review

272 Citations (SciVal)

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Abstract

Severe asthma imposes a significant burden on patients, families and healthcare systems. Management is difficult, due to disease heterogeneity, comorbidities, complexity in care pathways and differences between national or regional healthcare systems. Better understanding of the mechanisms has enabled a stratified approach to the management of severe asthma, supporting the use of targeted treatments with biologicals. However, there are still many issues that require further clarification. These include selection of a certain biological (as they all target overlapping disease phenotypes), the definition of response, strategies to enhance the responder rate, the duration of treatment and its regimen (in the clinic or home‐based) and its cost‐effectiveness. The EAACI Guidelines on the use of biologicals in severe asthma follow the GRADE approach in formulating recommendations for each biological and each outcome. In addition, a management algorithm for the use of biologicals in the clinic is proposed, together with future approaches and research priorities.

Original language	English
Pages (from-to)	14-44
Number of pages	31
Journal	Allergy
Volume	76
Issue number	1
Early online date	2 Jun 2020
DOIs	https://doi.org/10.1111/all.14425
Publication status	Published - Jan 2021

Bibliographical note

This is the peer reviewed version of the following article: Agache, I., Akdis, C., Akdis, M., Canonica, G.W., Casale, T., Chivato, T., Corren, J., Chu, D.K., Del Giacco, S., Eiwegger, T., Flood, B., Firinu, D., Gern, J.E., Hamelmann, E., Hanania, N., Hernández‐Martín, I., Knibb, R., Mäkelä, M., Nair, P., O13037Mahony, L., Papadopoulos, N.G., Papi, A., Park, H.‐S., Pérez de Llano, L., Pfaar, O., Quirce, S., Sastre, J., Shamji, M., Schwarze, J., Palomares, O. and Jutel, M. (2020), EAACI Biologicals Guidelines – Recommendations for severe asthma. Allergy. Accepted Author Manuscript., which has been published in final form at https://doi.org/10.1111/all.14425. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.

Keywords

GRADE
biologicals
cost-effectiveness
guidelines
severe asthma

Access to Document

10.1111/all.14425

EAACI Biologicals Guidelines – Recommendations for severe asthma
This is the peer reviewed version of the following article: Agache, I., Akdis, C., Akdis, M., Canonica, G.W., Casale, T., Chivato, T., Corren, J., Chu, D.K., Del Giacco, S., Eiwegger, T., Flood, B., Firinu, D., Gern, J.E., Hamelmann, E., Hanania, N., Hernández‐Martín, I., Knibb, R., Mäkelä, M., Nair, P., O13037Mahony, L., Papadopoulos, N.G., Papi, A., Park, H.‐S., Pérez de Llano, L., Pfaar, O., Quirce, S., Sastre, J., Shamji, M., Schwarze, J., Palomares, O. and Jutel, M. (2020), EAACI Biologicals Guidelines – Recommendations for severe asthma. Allergy. Accepted Author Manuscript., which has been published in final form at https://doi.org/10.1111/all.14425. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
Accepted author manuscript, 27 MB

Cite this

Agache, I., Akdis, C., Akdis, M., Canonica, G. W., Casale, T., Chivato, T., Corren, J., Chu, D. K., Del Giacco, S., Eiwegger, T., Flood, B., Firinu, D., Gern, J. E., Hamelmann, E., Hanania, N., Hernández‐martín, I., Knibb, R., Mäkelä, M., Nair, P., ... Jutel, M. (2021). EAACI Biologicals Guidelines – Recommendations for severe asthma. Allergy, 76(1), 14-44. https://doi.org/10.1111/all.14425

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title = "EAACI Biologicals Guidelines – Recommendations for severe asthma",

abstract = "Severe asthma imposes a significant burden on patients, families and healthcare systems. Management is difficult, due to disease heterogeneity, comorbidities, complexity in care pathways and differences between national or regional healthcare systems. Better understanding of the mechanisms has enabled a stratified approach to the management of severe asthma, supporting the use of targeted treatments with biologicals. However, there are still many issues that require further clarification. These include selection of a certain biological (as they all target overlapping disease phenotypes), the definition of response, strategies to enhance the responder rate, the duration of treatment and its regimen (in the clinic or home‐based) and its cost‐effectiveness. The EAACI Guidelines on the use of biologicals in severe asthma follow the GRADE approach in formulating recommendations for each biological and each outcome. In addition, a management algorithm for the use of biologicals in the clinic is proposed, together with future approaches and research priorities.",

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author = "Ioana Agache and Cezmi Akdis and Mubeccel Akdis and Canonica, \{Giorgio Walter\} and Thomas Casale and Tomas Chivato and Jonathan Corren and Chu, \{Derek K.\} and \{Del Giacco\}, Stefano and Thomas Eiwegger and Breda Flood and Davide Firinu and Gern, \{James E.\} and Eckard Hamelmann and Nicola Hanania and Irene Hern{\'a}ndez‐mart{\'i}n and Rebeca Knibb and Mika M{\"a}kel{\"a} and Parameswaran Nair and Liam O13037mahony and Papadopoulos, \{Nikolaos G.\} and Alberto Papi and Hae‐sim Park and \{P{\'e}rez De Llano\}, Luis and Oliver Pfaar and Santiago Quirce and Joaquin Sastre and Mohamed Shamji and Jurgen Schwarze and Oscar Palomares and Marek Jutel",

note = "This is the peer reviewed version of the following article: Agache, I., Akdis, C., Akdis, M., Canonica, G.W., Casale, T., Chivato, T., Corren, J., Chu, D.K., Del Giacco, S., Eiwegger, T., Flood, B., Firinu, D., Gern, J.E., Hamelmann, E., Hanania, N., Hern{\'a}ndez‐Mart{\'i}n, I., Knibb, R., M{\"a}kel{\"a}, M., Nair, P., O13037Mahony, L., Papadopoulos, N.G., Papi, A., Park, H.‐S., P{\'e}rez de Llano, L., Pfaar, O., Quirce, S., Sastre, J., Shamji, M., Schwarze, J., Palomares, O. and Jutel, M. (2020), EAACI Biologicals Guidelines – Recommendations for severe asthma. Allergy. Accepted Author Manuscript., which has been published in final form at https://doi.org/10.1111/all.14425. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.",

year = "2021",

month = jan,

doi = "10.1111/all.14425",

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volume = "76",

pages = "14--44",

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Agache, I, Akdis, C, Akdis, M, Canonica, GW, Casale, T, Chivato, T, Corren, J, Chu, DK, Del Giacco, S, Eiwegger, T, Flood, B, Firinu, D, Gern, JE, Hamelmann, E, Hanania, N, Hernández‐martín, I, Knibb, R, Mäkelä, M, Nair, P, O13037mahony, L, Papadopoulos, NG, Papi, A, Park, H, Pérez De Llano, L, Pfaar, O, Quirce, S, Sastre, J, Shamji, M, Schwarze, J, Palomares, O & Jutel, M 2021, 'EAACI Biologicals Guidelines – Recommendations for severe asthma', Allergy, vol. 76, no. 1, pp. 14-44. https://doi.org/10.1111/all.14425

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AU - Agache, Ioana

AU - Akdis, Cezmi

AU - Akdis, Mubeccel

AU - Canonica, Giorgio Walter

AU - Casale, Thomas

AU - Chivato, Tomas

AU - Corren, Jonathan

AU - Chu, Derek K.

AU - Del Giacco, Stefano

AU - Eiwegger, Thomas

AU - Flood, Breda

AU - Firinu, Davide

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AU - O13037mahony, Liam

AU - Papadopoulos, Nikolaos G.

AU - Papi, Alberto

AU - Park, Hae‐sim

AU - Pérez De Llano, Luis

AU - Pfaar, Oliver

AU - Quirce, Santiago

AU - Sastre, Joaquin

AU - Shamji, Mohamed

AU - Schwarze, Jurgen

AU - Palomares, Oscar

AU - Jutel, Marek

N1 - This is the peer reviewed version of the following article: Agache, I., Akdis, C., Akdis, M., Canonica, G.W., Casale, T., Chivato, T., Corren, J., Chu, D.K., Del Giacco, S., Eiwegger, T., Flood, B., Firinu, D., Gern, J.E., Hamelmann, E., Hanania, N., Hernández‐Martín, I., Knibb, R., Mäkelä, M., Nair, P., O13037Mahony, L., Papadopoulos, N.G., Papi, A., Park, H.‐S., Pérez de Llano, L., Pfaar, O., Quirce, S., Sastre, J., Shamji, M., Schwarze, J., Palomares, O. and Jutel, M. (2020), EAACI Biologicals Guidelines – Recommendations for severe asthma. Allergy. Accepted Author Manuscript., which has been published in final form at https://doi.org/10.1111/all.14425. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.

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KW - biologicals

KW - cost-effectiveness

KW - guidelines

KW - severe asthma

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M3 - Article

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SP - 14

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JO - Allergy

JF - Allergy

IS - 1

ER -

EAACI Biologicals Guidelines – Recommendations for severe asthma

Abstract

Bibliographical note

Keywords

Access to Document

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