Advantage of spirometry over oscillometry to detect dupilumab's effect on small airway dysfunction

• Published in: Allergology International Vol. 74; no. 3; pp. 468 - 471
• Main Authors: Shirai, Toshihiro, Hirai, Keita, Akamatsu, Taisuke, Mizumura, Kenji, Sasano, Hitoshi, Harada, Norihiro, Tanaka, Akihiko, Sagara, Hironori, Masaki, Katsunori, Fukunaga, Koichi, Kobayashi, Konomi, Nagase, Hiroyuki, Miyahara, Nobuaki, Kanehiro, Arihiko, Kitamura, Noboru, Sugihara, Naruhiko, Terada-Hirashima, Junko, Hojo, Masayuki, Chibana, Kazuyuki, Tagaya, Etsuko, Gon, Yasuhiro
• Format: Journal Article
• Language: English
• Published: England Elsevier B.V 01.07.2025; JAPANESE SOCIETY OF ALLERGOLOGY; Elsevier
• ISSN: 1323-8930; 1440-1592; 1440-1592
• DOI: 10.1016/j.alit.2024.12.004

Dear Editor, Small airway dysfunction (SAD) is associated with asthma severity, control, and exacerbations, and it is easily detected using spirometry and oscillometry. Although oscillometry is a reliable method to assess SAD, conflicting findings have been obtained concerning the effect of biologics on SAD in severe asthma. Possible factors for the discrepancy include a small sample size, retrospective nature, and patient selection. Thus, we assessed the effect of dupilumab on SAD in a prospective large study. This was a sub-analysis of the multicenter, prospective, single-arm, open-label observational study between July 2019 and May 2021. Subjects included 99 severe asthma patients with a score on the Asthma Control Questionnaire (ACQ)-5 of >0.75 and exacerbations in the previous year. Changes in parameters, including ACQ, Asthma Control Test (ACT), blood eosinophils, fractional exhaled nitric oxide (FeNO) (NIOX VERO, Aerocrine, Solna, Sweden), oscillometry and spirometry (MostGraph-01 and CHESTAC-33: Chest M.I., Tokyo, Japan), from baseline to 24 weeks of administration were examined.