OCS use in uncontrolled severe asthma in Canada

<bold>Introduction:</bold> In Canada, among the estimated 230,000–465,000 patients with severe asthma (SA), a subset face uncontrolled disease. Despite increased availability of biologic treatments (bx) for such patients, a proportion of patients still rely on oral corticosteroids (OCS). OCS use results in significant short- and long-term consequences emphasizing the need to improve understanding of the current treatment patterns for patients with SA in Canada. <bold>Aims:</bold> To characterise uncontrolled SA by examining OCS and bx claims patterns. <bold>Methods:</bold> This is part of ALERT, a retrospective descriptive study using longitudinal claims data from IQVIA’s Private Drug Plan database (2020–23). Adult patients with inferred asthma diagnoses were selected. Patients were further classified into those with SA and uncontrolled SA based on prescriptions for inhaler therapy or OCS, respectively. Regional variation was also assessed. <bold>Results:</bold> Of 88,377 patients with SA, 11,208 (12.7%) were deemed uncontrolled (60.9% female; mean age 56 years). Patients with uncontrolled SA had a mean of 4.4 OCS claims per patient, with 8% having ≥10 OCS claims over one year; furthermore, 72% had no bx claims. A heatmap indicates regional disparities in OCS use, with a region reaching as high as 21.6 claims per patient. <bold>Conclusions:</bold> Despite the widespread availability of bx covered by private payers, the majority of patients with uncontrolled SA had no bx claims but substantial OCS use, highlighting a significant gap in the management of SA. This emphasises the need for better education of healthcare providers and improved patient awareness of treatment options. Regional disparities amplify the need for targeted interventions to improve management strategies and reduce OCS use.