How to interpret FEOS score results
The FEOS score (FEV1, Exacerbations, Oral corticosteroids, Symptoms) allows clinicians to quantify response in severe uncontrolled patients who are being treated with monoclonal antibodies. 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.
The range of responses runs from 0 (worsening) to 100 (best possible response).The higher the score, the larger the response to mAbs.
This score quantifies the response, but it does not categorically classify asthma patients into “super-responders”, “responders”, “intermediate or indeterminate responders” and “non-responders”. In other words, the score does not provide an estimate of the level of asthma control attained after biologics therapy, but it reflects how much a given asthmatic improves. The quantification of the achieved improvement depends on the baseline disease burden, and those patients with poorer asthma control before biologic initiation have the potential to obtain higher scores after treatment than those with better pre-treatment clinical condition. The worse the clinical status before treatment, the greater the room for improvement.
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
Cómo interpretar los resultados del score FEOS
El score 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 en el que se desee cuantificar la respuesta (16, 24, 52, 76, 104 semanas…). La herramienta no debe ser usada para cuantificar la respuesta entre visitas una vez iniciado el anticuerpo monoclonal.
El valor que toma el score va desde 0 (empeoramiento) hasta 100 (mayor respuesta posible). Cuanto mayor sea el resultado, mayor es la respuesta al biológico.
El score cuantifica la respuesta, pero no clasifica a los pacientes con asma en “no respondedores”, “respuesta parcial”, “respuesta completa” o “superrespondedores”. Dicho de otra forma, esta herramienta no proporciona una clasificación de la respuesta conseguida después del tratamiento biológico, pero refleja cuánto ha mejorado el paciente respecto al punto de partida.
La cuantía de la mejoría obtenida depende del estado clínico inicial, y aquellos pacientes con peor situación clínica antes del tratamiento biológico tienen el potencial de obtener resultados mayores con el score que aquellos con una mejor situación de partida. Cuanto peor es el control del asma antes de iniciar el anticuerpo monoclonal, mayor es el margen de mejoría 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
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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