How to correctly calculate the FEOS score and FEOS rate.
The FEOS score (FEV1, Exacerbations, Oral corticosteroids, Symptoms) allows clinicians to quantify response in severe uncontrolled patients who are being treated with biologics. Therefore, it measures changes from baseline (clinical status before biologic initiation) to the follow-up time point (16 weeks, 24 weeks, 52 weeks, 76 weeks, 104 weeks…). The tool should not be used to measure changes between visits after biologic therapy has been started. Calculate the FEOS, each time WITH REGARD TO BASELINE CLINICAL SITUATION.
The range of responses runs from 0 (worsening) to 100 (best possible response). The higher the score, the larger the response to biologics.
The FEOS score tells us how much the patient has improved from baseline, but it does not tell us what percentage of the maximum possible score has been achieved. To do this, the FEOS rate must be calculated.
The FEOS rate - (FEOS/maximum possible score) x 100 - reflects the percentage improvement achieved over the maximum possible for each patient. To calculate it automatically, first determine the FEOS score and then refer to the table that indicates the patient's baseline status.
Reference:
Pérez de Llano L, Dávila I, Martínez-Moragón E, Domínguez-Ortega J, Almonacid C, Colás C, García-Rivero JL, Carmona L, García de Yébenes MJ, Cosío BG; FEOS Study Group.
Development of a Tool to Measure the Clinical Response to Biologic Therapy in Uncontrolled Severe Asthma: The FEV1, Exacerbations, Oral Corticosteroids, Symptoms Score. J Allergy Clin Immunol Pract. 2021 Jul;9(7):2725-2731. doi: 10.1016/j.jaip.2021.01.033. Epub 2021 Feb 4. PMID: 33549843
Laorden D, Zamarrón E, Romero D, Domínguez-Ortega J, Villamañán E, Losantos I, et al. Evaluation of FEOS score and super-responder criteria in a real-life cohort treated with anti-IL5/IL5R. Respir Med. 2023; 211: 107216. doi: 10.1016/j.rmed.2023.107216.
Estravís M, Pérez-Pazos J, Martin MJ, Ramos-González J, Gil-Melcón M, Martín-García C, et al. Quantitative and qualitative methods of evaluating response to biologics in severe asthma patients: Results from a real-world study. J Allergy Clin Immunol Pract. 2023; 11(3): 949-951.e2. doi: 10.1016/j.jaip.2022.11.009.
Cómo calcular correctamente FEOS score y FEOS rate
FEOS score (FEV1, Exacerbaciones, Orales corticoides, Síntomas) permite a los clínicos cuantificar la respuesta a un tratamiento biológico en pacientes con asma grave no controlada. Por lo tanto, mide cambios desde la situación basal (previa al inicio del biológico) hasta el momento del seguimiento (16 semanas, 24 semanas, 52 semanas, 76 semanas, 104 semanas…). La herramienta no debe utilizarse para medir cambios entre visitas una vez iniciada la terapia biológica. Calcule FEOS siempre CON RESPECTO A LA SITUACIÓN CLÍNICA BASAL.
El rango de respuesta oscila entre 0 (empeoramiento) hasta 100 (mayor respuesta posible). Cuanto mayor sea el resultado, mayor es la respuesta al biológico.
FEOS score cuantifica la mejoría del paciente respecto al punto de partida, pero no especifica qué porcentaje de la puntuación máxima posible se ha alcanzado. Para ello, debe calcularse el FEOS rate.
FEOS rate — (FEOS/puntuación máxima posible) x 100 — refleja el porcentaje de mejora logrado sobre el máximo potencial de cada paciente. Para calcularlo de forma automática, determine primero la puntuación FEOS score y, posteriormente, consulte la tabla que indica el estado basal del paciente.
Referencia:
Pérez de Llano L, Dávila I, Martínez-Moragón E, Domínguez-Ortega J, Almonacid C, Colás C, García-Rivero JL, Carmona L, García de Yébenes MJ, Cosío BG; FEOS Study Group.
Development of a Tool to Measure the Clinical Response to Biologic Therapy in Uncontrolled Severe Asthma: The FEV1, Exacerbations, Oral Corticosteroids, Symptoms Score. J Allergy Clin Immunol Pract. 2021 Jul;9(7):2725-2731. doi: 10.1016/j.jaip.2021.01.033. Epub 2021 Feb 4. PMID: 33549843
Laorden D, Zamarrón E, Romero D, Domínguez-Ortega J, Villamañán E, Losantos I, et al. Evaluation of FEOS score and super-responder criteria in a real-life cohort treated with anti-IL5/IL5R. Respir Med. 2023; 211: 107216. doi: 10.1016/j.rmed.2023.107216.
Estravís M, Pérez-Pazos J, Martin MJ, Ramos-González J, Gil-Melcón M, Martín-García C, et al. Quantitative and qualitative methods of evaluating response to biologics in severe asthma patients: Results from a real-world study. J Allergy Clin Immunol Pract. 2023; 11(3): 949-951.e2. doi: 10.1016/j.jaip.2022.11.009.
FEOS score
CRITERIA
SELECT
Maintenance systemic corticosteroid dose: change with respect to baseline
ACT, Asthma Control Test; FEV1, forced expiratory volume in 1 second.
Relative weights are converted into points for each item. Means, medians, and SDs of the relative importance of each item were reported as a percentage; the sum of each item’s relative importance (weight) is therefore 100%. Higher scores in the weighted system indicate better response to monoclonal antibodies.
* Or at least one if the patient was free of severe exacerbations.
† Or if the patient was free of exacerbations and continued to have no severeexacerbations
‡ Or if the patient was not receiving systemic corticosteroids and started the drug.
§ Or if the patient was not receiving systemic corticosteroids and remained without them.
Relative weights are converted into points for each item. Means, medians, and SDs of the relative importance of each item were reported as a percentage; the sum of each item’s relative importance (weight) is therefore 100%. Higher scores in the weighted system indicate better response to monoclonal antibodies.
* Or at least one if the patient was free of severe exacerbations.
† Or if the patient was free of exacerbations and continued to have no severeexacerbations
‡ Or if the patient was not receiving systemic corticosteroids and started the drug.
§ Or if the patient was not receiving systemic corticosteroids and remained without them.
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