Browse ATS 2021 Abstracts

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ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.

Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.

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Can Neutrophil to Lymphocyte Ratio Predict Response to Biological Therapy in Severe Uncontrolled Asthma?

Session Title
TP10 - TP010 CLINICAL AND POPULATION-LEVEL STUDIES OF ASTHMA
Abstract
A1462 - Can Neutrophil to Lymphocyte Ratio Predict Response to Biological Therapy in Severe Uncontrolled Asthma?
Author Block: I. Yousef1, Z. L. Dorey-Stein2, A. B. Karanam3, S. Tittaferrante4, T. Buckey4, K. V. Shenoy5; 1Thoracic medicine and surgery, Temple University Hospital, Philadelphia, PA, United States, 2Thoracic Medicine and Surgery, Temple University, Philadelphia, PA, United States, 3Department of Internal Medicine, Temple University, Philadelphia, PA, United States, 4Internal Medicine, Temple University Hospital, Philadelphia, PA, United States, 5Temple Lung Center, Philadelphia, PA, United States.
Rationale Asthma is a complex heterogeneous disease of chronic intermittent inflammation of the airways. Uncontrolled severe asthma is associated with increased mortality, morbidity, and poor quality of life. The development of monoclonal antibody therapy has added to the arsenal of treatments for severe asthma, however, despite these advances, there remains a subset of asthma patients on monoclonal antibody therapy who remain symptomatic with excessive utilization of the healthcare system. Neutrophil to lymphocyte ratio [NLR] has been associated with the severity of multiple diseases, including the severity of asthma exacerbation. The objective of this study is to investigate if NLR can predict response to biologics in severe asthma. Methods A single-center retrospective study of patients with uncontrolled severe persistent asthma initiated on any form of monoclonal antibody therapy from January 1, 2015, to June 1, 2019. Inclusion criteria included uncontrolled asthma on monoclonal antibody therapy, CBC with differential completed within one year of treatment initiation off corticosteroids for at least 4 weeks and a minimum of 4 outpatient follow up visits with pulmonologist after starting biological therapy. Treatment failure was defined as discontinuation or changing monoclonal antibody due to persistent exacerbations or an inability to decrease chronic oral corticosteroid dose. Results: 62 patients were identified that met the above inclusion criteria. 46% of the patients were identified in the treatment failure cohort and 54% were well controlled on monoclonal antibody therapy and served as a control cohort. Demographics are detailed in table 1. Baseline mean NLR in the failure group was 4.11 compared to 3.33 in the control group (P= 0.58). Baseline mean Eosinophil to lymphocyte ratio in the failure group 0.24 compared to 0.25 in the control group (P= 0.37). Conclusion: Baseline NLR is not predictive of monoclonal antibody treatment failure in uncontrolled asthmatic.