Impact of Initiating Biologics in Patients With Severe Asthma on Long-Term Oral Corticosteroids or Frequent Rescue Steroids (GLITTER): Data From the International Severe Asthma Registry

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • João De Almeida Lopes Da Fonseca

    Autor

Participantes de fora da FMUP

  • Chen, WJ
  • Tran, TN
  • Sadatsafavi, M
  • Murray, R
  • Wong, NCB
  • Ali, N
  • Ariti, C
  • Bulathsinhala, L
  • Garcia, E
  • FitzGerald, JM
  • Alacqua, M
  • Al-Ahmad, M
  • Altraja, A
  • Al-Lehebi, R
  • Bhutani, M
  • Bjermer, L
  • Bjerrum, AS
  • Bourdin, A
  • von Bülow, A
  • Busby, J
  • Canonica, GW
  • Carter, V
  • Christoff, GC
  • Cosio, BG
  • Costello, RW
  • Gibson, PG
  • Yoo, KH
  • Heaney, LG
  • Heffler, E
  • Hew, M
  • Hilberg, O
  • Hoyte, F
  • Iwanaga, T
  • Jackson, DJ
  • Jones, RC
  • Koh, MS
  • Kuna, P
  • Larenas-Linnemann, D
  • Lehmann, S
  • Lehtimäki, L
  • Lyu, J
  • Mahboub, B
  • Maspero, J
  • Menzies-Gow, AN
  • Newell, A
  • Sirena, C
  • Papadopoulos, NG
  • Papaioannou, AI
  • Perez-de-Llano, L
  • Perng, DW
  • Peters, M
  • Pfeffer, PE
  • Porsbjerg, CM
  • Popov, TA
  • Rhee, CK
  • Salvi, S
  • Taillé, C
  • Taube, C
  • Torres-Duque, CA
  • Ulrik, C
  • Ra, SW
  • Wang, E
  • Wechsler, ME
  • Price, DB

Unidades de investigação

Abstract

BACKGROUND: Effectiveness of biologics has neither been established in patients with high oral corticosteroid exposure (HOCS) nor been compared with effectiveness of continuing with HOCS alone. OBJECTIVE: To examine the effectiveness of initiating biologics in a large, real-world cohort of adult patients with severe asthma and HOCS. METHODS: This was a propensity scoreematched, prospective cohort study using data from the International Severe Asthma Registry. Between January 2015 and February 2021, patients with severe asthma and HOCS (long-term OCSs for >= 1 year or >= 4 courses of rescue OCSs within a 12-month period) were identified. Biologic initiators were identified and, using propensity scores, matched 1:1 with noninitiators. The impact of biologic initiation on asthma outcomes was assessed using generalized linear models. RESULTS: We identified 996 matched pairs of patients. Both groups improved over the 12-month follow-up period, but improvement was greater for biologic initiators. Biologic initiation was associated with a 72.9% reduction in the average number of exacerbations per year versus noninitiators (0.64 vs 2.06; rate ratio, 0.27 [95% CI, 0.10-0.71]). Biologic initiators were 2.2 times more likely than noninitiators to take a daily long-term OCS dose of less than 5 mg (risk probability, 49.6% vs 22.5%; P [.002) and had a lower risk of asthma-related emergency department visits (relative risk, 0.35 [95% CI, 0.21-0.58]; rate ratio, 0.26 [0.14-0.48]) and hospitalizations (relative risk, 0.31 [95% CI, 0.18-0.52]; rate ratio, 0.25 [0.13-0.48]). CONCLUSIONS: In a real-world setting, including patients with severe asthma and HOCS from 19 countries, and within an environment of clinical improvement, initiation of biologics was associated with further improvements across multiple asthma outcomes, including exacerbation rate, OCS exposure, and health care resource utilization. (C) 2023 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

Dados da publicação

ISSN/ISSNe:
2213-2198, 2213-2201

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE  Elsevier

Tipo:
Article
Páginas:
2732-2747

Citações Recebidas na Web of Science: 4

Documentos

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Keywords

  • Biologics; Effectiveness; ISAR; Oral corticosteroids; Real life

Proyectos asociados

Prevalence and Characterisation of Asthma Patients According to Disease Severity in Portugal (EPI-ASTHMA) - NCT05169619

Investigador Principal: João de Almeida Lopes da Fonseca

Estudo Clínico Observacional (EPI-ASTHMA) . AstraZeneca . 2021

Effect of a Mobile App on Improving Asthma Control in Adolescents and Adults With Persistent Asthma: A Pilot Randomized Multicentre, Superiority Clinical Trial (mINSPIRERS) - NCT05129527

Investigador Principal: João de Almeida Lopes da Fonseca

Ensaio Clínico Académico (mINSPIRERS) . 2021

Utilização em estudos observacionais do Registo de Asma Grave Portugal.

Investigador Principal: João de Almeida Lopes da Fonseca

Estudo Observacional Académico (RAG) . 2020

Clinical Research Collaboration Severe Heterogenous Asthma Research collaboration, Patient-centered (CRC SHARP).

Investigador Principal: João de Almeida Lopes da Fonseca

Estudo Clínico Observacional (SHARP) . European Respiratory Society . 2021

Multidimensional phenotyping of severe asthma patients and its impact on disease control and therapeutic response - analysis from the Portuguese Severe Asthma Registry.

Investigador Principal: João de Almeida Lopes da Fonseca

Estudo Clínico Observacional (RAG-SPP-GSK) . SPPneumologia . 2022

BREATHE - An oBservational, pRimary data study to characterize severe AsThma pHenotypes and assEss disease burden across the EUCAN region.

Investigador Principal: João de Almeida Lopes da Fonseca

Estudo Clínico Observacional (RAG-AZ-BREATHE) . AstraZeneca . 2022

Efficiency in Spine Care ? Assessing outcomes and costs to inform healthcare improvement

Investigador Principal: João de Almeida Lopes da Fonseca

Estudo Clínico Académico . 2022

Use of secondary data, health technology assessment methods and economic modelling applied to penicillin allergy

Investigador Principal: João de Almeida Lopes da Fonseca

Estudo Clínico Académico . 2020

Using different data sources for the identification of asthma patients and those at high risk of adverse outcomes

Investigador Principal: João de Almeida Lopes da Fonseca

Estudo Clínico Académico . 2020

Phenotypes of Chronic Diseases of the Airways: Towards Multidimensional Data -Driven Profiling

Investigador Principal: João de Almeida Lopes da Fonseca

Estudo Clínico Académico . 2020

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