Impact of biologic initiation on oral corticosteroids in the International Severe Asthma Registry and the Optimum Patient Care Research Database: a pooled analysis

This study estimated the impact of biologic initiation on using oral corticosteroids (OCS) in severe asthma (SA) patients from real-life specialist and primary care settings. Adult patients with SA were identified from the International Severe Asthma Registry (ISAR, specialist care) and the Optimum Patient Care Research Database (OPCRD, primary care, UK). Biologic initiators were identified and propensity-score matched with non-initiators. Impact of biologic initiation on total OCS (TOCS, including bursts for exacerbations) daily dose in the 1st- and 2nd-year follow-up period was assessed using multivariable generalized linear models. Among 8060 patients (ISAR 34%, OPCRD 76%), the risk ratios (RR) of biologic initiators achieving zero TOCS in year 1 and 2 of follow up were 1.53 (95% CI: 1.28-1.82) and 1.72 (1.43-2.07), while the RRs of achieving low daily dose (0-5 mg) were 1.07 (1.00-1.16) and 1.11 (1.03-1.19), respectively. Biologic initiators also had a greater likelihood of achieving any reduction in TOCS and optimal (≥75%) reduction in both year 1 and 2 of follow-up (Table 1). Compared to non-initiators, biologic initiators had greater reduction in TOCS daily dose in both 1st (mg/day, -3.2 vs -2.0) and 2nd (−4.2 vs -3.5) year (p<.001). Biologic initiation results in reduced OCS burden in patients with SA over two years versus usual care. <fig><object-id>erj;64/suppl_68/PA2175/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>

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Published
2024-09-14
DOI
https://doi.org/10.1183/13993003.congress-2024.pa2175
Primary Topic
Asthma and respiratory diseases
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article
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article

Impact of biologic initiation on oral corticosteroids in the International Severe Asthma Registry and the Optimum Patient Care Research Database: a pooled analysis

Lakmini Bulathsinhala, Piotr Kuna, Matthew Peters, Guy Brusselle et al.
Asthma and respiratory diseases
article

Impact of biologic initiation on oral corticosteroids in the International Severe Asthma Registry and the Optimum Patient Care Research Database: a pooled analysis

Lakmini Bulathsinhala, Piotr Kuna, Matthew Peters, Guy Brusselle, Liam Gabriel Heaney, Fernando Saldarini, Dóra Lúðvíksdóttir, Benjamin Emmanuel, Wenjia Chen, Ruth Murray, Chau‐Chyun Sheu, Andrew Menzies‐Gow, Florence Schleich, Trung N. Tran, Richard W. Costello, Chin Kook Rhee, Libardo Jiménez-Maldonado, Zsuzsanna Csoma, Delbert R. Dorscheid, Michael E. Wechsler, George Christoff, Désirée Larenas‐Linnemann, Todor A. Popov, ARNAUD AB BOURDIN, Ghislaine Scélo, Alan Altraja, Eileen Wang, David Price, Charlotte Suppli Ulrik, Paul Pfeffer, Céline Bergeron, Κonstantinos Κostikas, Mona Sulaiman Al-Ahmad, Neda Stjepanovic, Yuji Tohda, Rohit Katial, Paulo Márcio Pitrez, Enrico Marco Heffler, Belinda Cochrane, Luis Pérez de Llano, Adeeb A. Bulkhi, Lauri Lehtimäki, Aaron Beastall, Yah Ru Juang, Anqi Liu, David J. Jackson, Jorge Ferreira, Bassam Mahboub, Leif Bjermer, Bernt Bøgvald Aarli
article en

Abstract

This study estimated the impact of biologic initiation on using oral corticosteroids (OCS) in severe asthma (SA) patients from real-life specialist and primary care settings. Adult patients with SA were identified from the International Severe Asthma Registry (ISAR, specialist care) and the Optimum Patient Care Research Database (OPCRD, primary care, UK). Biologic initiators were identified and propensity-score matched with non-initiators. Impact of biologic initiation on total OCS (TOCS, including bursts for exacerbations) daily dose in the 1st- and 2nd-year follow-up period was assessed using multivariable generalized linear models. Among 8060 patients (ISAR 34%, OPCRD 76%), the risk ratios (RR) of biologic initiators achieving zero TOCS in year 1 and 2 of follow up were 1.53 (95% CI: 1.28-1.82) and 1.72 (1.43-2.07), while the RRs of achieving low daily dose (0-5 mg) were 1.07 (1.00-1.16) and 1.11 (1.03-1.19), respectively. Biologic initiators also had a greater likelihood of achieving any reduction in TOCS and optimal (≥75%) reduction in both year 1 and 2 of follow-up (Table 1). Compared to non-initiators, biologic initiators had greater reduction in TOCS daily dose in both 1st (mg/day, -3.2 vs -2.0) and 2nd (−4.2 vs -3.5) year (p<.001). Biologic initiation results in reduced OCS burden in patients with SA over two years versus usual care. <fig><object-id>erj;64/suppl_68/PA2175/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>

Reykjavík University (IS), Queen's University Belfast (GB), Camden and Campbelltown Hospitals (AU), Dubai Health Authority (AE), Centre National de la Recherche Scientifique (FR), Concord Hospital (US), University of British Columbia (CA), Kaohsiung Medical University (TW), Inserm (FR), University of Liège (BE), University of Iceland (IS), National University of Singapore (SG), King's College London (GB), University of Ioannina (GR), Université de Montpellier (FR), Umm al-Qura University (SA), Barts Health NHS Trust (GB), Concord Repatriation General Hospital (AU), Santa Casa Hospital (BR), Haukeland University Hospital (NO), Ghent University Hospital (BE), Beaumont Hospital (IE), Hvidovre Hospital (DK), Tartu University Hospital (EE), Vancouver General Hospital (CA), Medical University of Sofia (BG), National Jewish Health (US), Kuwait University (KW), Physiologie et Médecine Expérimentale du Coeur et des Muscles (FR), St. Mary's Hospital (US), Kindai University Hospital (JP), Hospital Médica Sur (MX), University Hospital St. Ivan Rilski (BG), National University Hospital of Iceland (IS), AstraZeneca (France) (FR), St. Mary's Hospital (US), Observational & Pragmatic Research Institute (SG), Abzena (United Kingdom) (GB), Medical University of Lodz (PL), Tampere University Hospital (FI), Office of Patient Care Services (US), Tampere University (FI), Hospital Donación Francisco Santojanni (AR), AstraZeneca (Finland) (FI), Skåne University Hospital (SE), AstraZeneca (Italy) (IT), Centro Hospitalar de Vila Nova de Gaia (PT), Hospital Universitario Lucus Augusti (ES), National University Health System (SG), Colombian Association of Surgery (CO), The Catholic University of Korea Seoul St. Mary's Hospital (KR), IRCCS Humanitas Research Hospital (IT), Országos Korányi Tbc és Pulmonológiai Intézet (HU), University of Colorado Denver (US)
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Asthma and respiratory diseases
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