Characterization of Patients in the International Severe Asthma Registry with High Steroid Exposure Who Did or Did Not Initiate Biologic Therapy

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • João De Almeida Lopes Da Fonseca

    Autor

Participantes de fora da FMUP

  • Chen, WJ
  • Sadatsafavi, M
  • Tran, TN
  • Murray, RB
  • Wong, CBN
  • Ali, N
  • Ariti, C
  • Gil, EG
  • Newell, A
  • Alacqua, M
  • Al-Ahmad, M
  • Altraja, A
  • Al-Lehebi, R
  • Bhutani, M
  • Bjermer, L
  • Bjerrum, AS
  • Bourdin, A
  • Bulathsinhala, L
  • von Bülow, A
  • Busby, J
  • Canonica, GW
  • Carter, V
  • Christoff, GC
  • Cosio, BG
  • Costello, RW
  • FitzGerald, JM
  • Ha Yoo, K
  • 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, LA
  • Lyu, J
  • Mahboub, B
  • Maspero, J
  • Menzies-Gow, AN
  • Sirena, C
  • Papadopoulos, N
  • Papaioannou, AI
  • de Llano, LP
  • Perng, DW
  • Peters, M
  • Pfeffer, PE
  • Porsbjerg, CM
  • Popov, TA
  • Rhee, CK
  • Salvi, S
  • Taillé, C
  • Taube, C
  • Torres-Duque, CA
  • Ulrik, CS
  • Ra, SW
  • Wang, E
  • Wechsler, ME
  • Price, DB

Unidades de investigação

Abstract

Background: Many severe asthma patients with high oral corticosteroid exposure (HOCS) often do not initiate biologics despite being eligible. This study aimed to compare the characteristics of severe asthma patients with HOCS who did and did not initiate biologics. Methods: Baseline characteristics of patients with HOCS (long-term maintenance OCS therapy for at least 1 year, or >= 4 courses of steroid bursts in a year) from the International Severe Asthma Registry (ISAR; https://isaregistries.org/), who initiated or did not initiate biologics (anti-lgE, anti-IL5/5R or anti-IL4R), were described at the time of biologic initiation or registry enrolment. Statistical relationships were tested using Pearson's chi-squared tests for categorical variables, and t-tests for continuous variables, adjusting for potential errors in multiple comparisons. Results: Between January 2015 and February 2021, we identified 1412 adult patients with severe asthma from 19 countries that met our inclusion criteria of HOCS, of whom 996 (70.5%) initiated a biologic and 416 (29.5%) did not. The frequency of biologic initiation varied across geographical regions. Those who initiated a biologic were more likely to have higher blood eosinophil count (483 vs 399 cells/mu L, p=0.003), serious infections (49.0% vs 13.3%, p<0.001), nasal polyps (35.2% vs 23.6%, p<0.001), airflow limitation (56.8% vs 51.8%, p=0.013), and uncontrolled asthma (80.8% vs 73.2%, p=0.004) despite greater conventional treatment adherence than those who did not start a biologic. Both groups had similar annual asthma exacerbation rates in the previous 12 months (5.7 vs 5.3, p=0.147). Conclusion: Around one third of severe HOCS asthma patients did not receive biologics despite a similar high burden of asthma exacerbations as those who initiated a biologic therapy. Other disease characteristics such as eosinophilic phenotype, serious infectious events, nasal polyps, airflow limitation and lack of asthma control appear to dictate biologic use.

© 2022 Chen et al.

Dados da publicação

ISSN/ISSNe:
1178-6965, 1178-6965

Journal of Asthma and Allergy  Dove Medical Press Ltd.

Tipo:
Article
Páginas:
1491-1510
Link para outro recurso:
www.scopus.com

Citações Recebidas na Web of Science: 2

Citações Recebidas na Scopus: 10

Documentos

  • Não há documentos

Métricas

Filiações mostrar / ocultar

Keywords

  • severe asthma; biologics; real-world; treatment pattern; patient characteristics

Financiamento

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

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

Citar a publicação

Partilhar a publicação