Oral corticosteroids and biologics use in the Greek Severe Asthma Registry (GSAR)

<bold>Background-aims:</bold> Data regarding the treatment of severe asthma (SA) patients with maintenance OCS (mOCS) and biologics in Greece is limited. Our study aims to address this gap. <bold>Methods:</bold> We analyzed data regarding OCS and biologic use in SA patients from the GSAR of the Hellenic Thoracic Society. <bold>Results:</bold> 619 patients were analyzed, 19% of whom were on mOCS. The majority (65%) of patients were female, with a mean age of 57.3 years, and 68% had late-onset asthma (LOA), with a median duration of 21 years. Patients on mOCS had less well-controlled asthma (ACT ≥20; 35.8 vs 64%), worse lung function (FEV1% 66.1 vs 74.1) and higher exacerbation rate (2.63 vs 1.89) compared to the non-mOCS group. GERD and osteoporosis were the most common comorbidities in the mOCS group. Biologics were receiving 57% of patients (61% female, mean age of 56.8 years), 67% of whom had late-onset asthma and 22% were also on mOCS. Patients on biologics had better asthma control (ACT≥20;61.8 vs 50.5) despite having higher exacerbations rate in the previous year (2.24 vs 1.43) and worse pulmonary function (FEV1%, 73 vs 81) than those not receiving biologics. Atopy, nasal polyposis and GERD were more common among biologics’ users compared to the non-biologics group (75.6 vs 60.2%, 31.5 vs 16.4% and 33.4 vs 22.4%, respectively). Notably, biologic switchers (60.5%) had higher rates of exacerbations (2.99 vs 2.05) and allergic rhinitis (74 vs 61.3%). <bold>Conclusions:</bold> Although the majority of SA asthma patients in the GSAR receive biologics, a significant proportion are still on mOCS. The administration of biological therapies in appropriately selected patients may result in better clinical outcomes with fewer OCS-related side effects.

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Published
2024-09-14
DOI
https://doi.org/10.1183/13993003.congress-2024.pa2174
Primary Topic
Asthma and respiratory diseases
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article
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article

Oral corticosteroids and biologics use in the Greek Severe Asthma Registry (GSAR)

Νikolaos Tzanakis, Pavlos Michailopoulos, Κonstantinos Κatsoulis, Andrianna Papaioannou et al.
Asthma and respiratory diseases
article

Oral corticosteroids and biologics use in the Greek Severe Asthma Registry (GSAR)

Νikolaos Tzanakis, Pavlos Michailopoulos, Κonstantinos Κatsoulis, Andrianna Papaioannou, Dimitrios Latsios, Maria Kipourou, Evangelia Fouka, Despoina Papakosta, Stylianos Vittorakis, Dimitra Siopi, Εleftherios Ζervas, Κonstantinos Porpodis, Katerina Markopoulou, Νikoletta Ρovina, Mina Gaga, Petros Bakakos, Angeliki Florou, Eleni Tzortzaki, Ourania S. Kotsiou, Katerina Dimakou, Athanasios Konstantinidis, Paschalis Steiropoulos, Stelios Loukides, Κonstantinos Κostikas, Κonstantinos Bartziokas, Μiltiadis Μarkatos, Pantelis Avarlis, Christina Gratziou, Georgios Hillas, Κonstantinos Samitas, Paraskevi Κatsaounou, Maria Kallieri, Εleni Gaki, Niki Georgatou, Panagiota Karidi, Athanasios Solakis, Georgios Zaharis, Konstantinos Charitopoulos
article en

Abstract

<bold>Background-aims:</bold> Data regarding the treatment of severe asthma (SA) patients with maintenance OCS (mOCS) and biologics in Greece is limited. Our study aims to address this gap. <bold>Methods:</bold> We analyzed data regarding OCS and biologic use in SA patients from the GSAR of the Hellenic Thoracic Society. <bold>Results:</bold> 619 patients were analyzed, 19% of whom were on mOCS. The majority (65%) of patients were female, with a mean age of 57.3 years, and 68% had late-onset asthma (LOA), with a median duration of 21 years. Patients on mOCS had less well-controlled asthma (ACT ≥20; 35.8 vs 64%), worse lung function (FEV1% 66.1 vs 74.1) and higher exacerbation rate (2.63 vs 1.89) compared to the non-mOCS group. GERD and osteoporosis were the most common comorbidities in the mOCS group. Biologics were receiving 57% of patients (61% female, mean age of 56.8 years), 67% of whom had late-onset asthma and 22% were also on mOCS. Patients on biologics had better asthma control (ACT≥20;61.8 vs 50.5) despite having higher exacerbations rate in the previous year (2.24 vs 1.43) and worse pulmonary function (FEV1%, 73 vs 81) than those not receiving biologics. Atopy, nasal polyposis and GERD were more common among biologics’ users compared to the non-biologics group (75.6 vs 60.2%, 31.5 vs 16.4% and 33.4 vs 22.4%, respectively). Notably, biologic switchers (60.5%) had higher rates of exacerbations (2.99 vs 2.05) and allergic rhinitis (74 vs 61.3%). <bold>Conclusions:</bold> Although the majority of SA asthma patients in the GSAR receive biologics, a significant proportion are still on mOCS. The administration of biological therapies in appropriately selected patients may result in better clinical outcomes with fewer OCS-related side effects.

Mediterranean Agronomic Institute of Chania (GR), University of Thessaly (GR), Democritus University of Thrace (GR), University of Ioannina (GR), National and Kapodistrian University of Athens (GR), Technological Educational Institute of Peloponnese (GR), Cosmote (Greece) (GR), 401 General Military Hospital of Athens (GR), Hellenic Agency for Local Development and Local Government (GR), General Hospital of Drama (GR), Laiko General Hospital of Athens (GR), 424 General Military Hospital (GR), Development Agency of Karditsa (GR), Athens Medical Center (GR), University Hospital of Heraklion (GR), University General Hospital Attikon (GR), KAT General Hospital of Attica (GR), G. Papanikolaou General Hospital (GR), e-Trikala (Greece) (GR), Evangelismos Hospital (GR), Sotiria General Hospital (GR)
Good health and well-being
Openalex Percentile: Top 72%
Asthma and respiratory diseases
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